3T MRI半定量冈上肌脂肪浸润程度与慢性肩袖撕裂的相关性分析

3T MRI study on the relationship between the degree of fat infiltration in supraspinatus muscle and chronic rotator cuff tears

目的 探讨3T MRI半定量冈上肌脂肪浸润程度与慢性肩袖损伤的相关性。方法 选取经手术或关节镜证实的95例慢性肩袖损伤患者,所有患者均行3T MRI检查。MRI冠状位测量肱-肩距离、斜矢状位记录肩峰形态以及采用Goutallier分类改良方法评估冈上肌脂肪浸润程度分级。所有患者依据冈上肌腱损伤程度分为退变组,部分撕裂组和完全撕裂组。结果 1)冈上肌腱退变组、部分性撕裂组及完全性撕裂组与冈上肌脂肪浸润有显著相关性(P<0.01)。2)冈上肌腱退变组、部分性撕裂组及完全性撕裂组性别、年龄、肩峰下间隙及肩峰形态差异无统计学意义(P>0.05)。3)进一步两两比较显示,冈上肌腱退变组冈上肌脂肪浸润程度分级小于部分性撕裂组及完全性撕裂组,差异具有统计学意义(P<0.05);部分性撕裂组小于完全性撕裂组,差异有统计学意义(P<0.05)。结论 3T MRI可半定量评估冈上肌脂肪浸润程度,冈上肌脂肪浸润程度与其损伤呈正相关。

Objective To investigate the relationship between 3TMRI semiquantitative supraspinatus muscle fat infiltration and chronic rotator cuff injury.Methods 95 patients with rotator cuff tears confirmed by operation or arthroscopy were included in the study,and all patients were examined by 3 T MRI.The humeral-shoulder distance was measured by coronal MRI and the superior supraspinatus fat infiltration grading was assessed by the improved Goutallier classification.Patients were classified to degeneration group,partial tear group and completed tear group.Results 1)Fat infiltration of supraspinatus muscle was significantly correlated with supraspinatus tendon degeneration group,partial tear group and complete tear group(P<0.01);.2)There was no significant difference in gender,age,subacromial space and acromion morphology between supraspinatus tendon degeneration group,partial tear group and complete tear group(P>0.05);and 3)Further comparison between two groups showed that the fat infiltration of supraspinatus tendon degeneration group was less than that of partial tear group and complete tear group(P<0.05),and partial tear group was less than that of complete tear group,the difference was statistically significant(P<0.05).Conclusion The more serious the fat infiltration of supraspinatus,the more serious the injury of supraspinatus tendon may be.