X线联合磁共振成像评价中风后肩关节半脱位

Evaluation of shoulder subluxation after stroke by X-ray combined with MRI

目的探讨X线、磁共振成像联合评价中风后肩关节半脱位的应用价值。方法收集黑龙江中医药大学附属第二医院中风合并肩关节半脱位患者60例,对患侧与健侧进行X线、磁共振成像检查,观察中风患者肩关节损伤情况。结果患侧肩峰至肱骨头的间距(acromio humeral interval,AHI)值为(25.11±2.98)mm,患侧肩关节不同程度退变者共41例(68.33%),其中双侧肩关节退变37例(61.67%);中风后肩关节半脱位患侧肩胛下滑囊(subacromial-subdeltoidbursa,SA-SD)、盂肱关节、肱二头肌腱鞘积液、肩袖损伤的发病率分别为61.67%、85.00%、55.00%和71.67%,分别与健侧13.33%、16.67%、11.67%和10.00%比较,差异均有统计学意义(P<0.05)。结论中风后肩关节半脱位患者肩周常伴渗出改变,以盂肱关节积液最为好发;X线联合磁共振成像检查可以对中风后肩关节半脱位起到全面评价的作用。

Objective To explore the application value of X-ray combined with MRI in the evaluation of shoulder subluxation after stroke.Methods Sixty stroke patients with shoulder subluxation in the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were collected.X-ray and MRI were performed on the affected side and the healthy side to observe the shoulder injury of patients with shoulder subluxation after stroke.Results Acromio humeral interval(AHI)of the affected side was(25.11±2.98)mm,and 41 cases(68.33%)were affected by shoulder joint degeneration,37 of which were bilateral shoulder joint degeneration(61.67%).The incidence rate of subacromial-subdeltoidbursa(SA-SD),glenohumeral joint,biceps tendon sheath and rotator cuff injury in the affected side of shoulder joint subluxation after stroke were 61.67%,85.00%,55.00%and 71.67%,respectively,and there were significant differences compared with healthy side 13.33%,16.67%,11.67%and 10.00%(P<0.05).Conclusion The patients with shoulder subluxation after stroke often have exudative changes around the shoulder,especially in glenohumeral joint effusion;X-ray combined with MRI can play a comprehensive evaluation role in shoulder subluxation after stroke.