盂肱下韧带MR影像对冻结肩的诊断价值

Diagnostic value of frozen shoulder with MR manifestations of inferior glenohumeral ligament

目的探讨盂肱下韧带MR表现对冻结肩的诊断价值。方法分析我院间141例肩关节MR影像,将临床诊断为冻结肩48例患者作为冻结肩组、经关节镜证实的肩袖部分撕裂37例患者作为肩袖撕裂组、正常对照组56例。在斜冠状位T_2WI脂肪饱和序列上评估盂肱下韧带T_2信号强度、有无关节囊外高信号层并测量盂肱下韧带厚度。结果盂肱下韧带T_2WI脂肪饱和序列上呈高信号:冻结肩组41例、肩袖撕裂组5例、对照组5例,其诊断冻结肩的准确性88%、敏感性85%、特异性89%、阳性预测值80%、阴性预测值92%;斜冠状位T_2WI脂肪饱和序列上盂肱下韧带厚度:冻结肩组(n=48)(5.22±1.03)mm、肩袖撕裂组(n=37)(3.95±0.69)mm、对照组(n=56)(3.96±0.72)mm,冻结肩组厚度明显大于肩袖撕裂组、对照组,差异比较具有统计学意义(P<0.001),肩袖撕裂组与对照组差异比较无统计学意义(P>0.05)。结论盂肱下韧带T_2WI脂肪饱和序列上信号增高、增厚表现有助于冻结肩诊断。

Objective To evaluate diagnostic value of frozen shoulder with MR manifestations of inferior glenohumeral ligament(IGHL). Methods The MRI images of 141 cases recieved from April to December 2016 were retrospectively analyzed. There were 37 shoulder joints with clinical daignosis of frozen shoulder(FS) regarded as the FS group. There were 38 subjects with partial-thickness supraspinatus tendon tear confirmed by arthroscopy regarded as rotator cuff group. There were 56 shoulder joints without any diagnosis regarded as the control group. The T2 signal intensity at IGHL, the thickness of IGHL and whether there was extracapsular heperintense layer were evaluated on T2-weighted fat-saturated oblique coronal images. Results T2 hyperintensity of IGHL were found in 41 cases(41/48) with frozen shoulder, 7 cases(7/37) with superior cuff tear, 5 cases(5/56)with the control group. The T2 hyperintensity diagnostic values of IGHL were as follows: veracity was 88%, sensibility 85%, specificity 89%, positive predictive value 80%, and negative predictive value 92%. The thickness of IGHL on oblique coronal plane was(5.22±1.03) mm in the patients with FS(n=48);(3.95±0.69) mm in patients with superior cuff tear(n=37);(3.96±0.72) mm in the control group(n=56). The thickness of IGHL was greatest than the other two groups;The difference was significant(P<0.001). The difference of mean thickness of IGHL between the partial tear of rotator cuff group and the control group was not statistically significant(P>0.05). Conclusion The T2 hyperintensity and thickening of IGHL on T2-weighted fat-saturated will be helpful for the diagnosis of frozen shoulder.