超声评估肩峰撞击综合征患者肩峰下滑囊的临床研究

Assessment of subacromial bursa by ultrasound in patients with subacromial impingement syndrome

目的:对比分析肩峰撞击综合征(SIS)患者与健康人群肩峰下滑囊(SAB)的超声图像特征,探讨一种简便而准确的SAB超声评估方法。方法:选取确诊为SIS的患者58例(病例组)共65个患肩,以及无任何肩关节不适的健康志愿者50例(正常对照组)共50个优势肩。均行肩关节超声检查,观察SAB是否增厚、有无积液等,并分别在肩胛下肌腱长轴及短轴切面、冈上肌腱长轴及短轴切面测量SAB厚度。结果:病例组滑囊增厚、积液发生率明显高于正常对照组,差异有统计学意义(χ2=71.265,P<0.001;χ2=15.345,P<0.001)。病例组和正常对照组冈上肌腱短轴切面测得的SAB平均厚度均大于肩胛下肌腱长轴、短轴及冈上肌腱长轴切面所测结果,差异有统计学意义(均P<0.05)。结论:超声能准确评估SIS患者SAB增厚、积液扩张等病理改变,冈上肌腱短轴切面测量SAB厚度简单可靠。

Objective: To explore a simple and accurate approach of assessing subacromial bursa(SAB) by comparing the ultrasound findings between patients with subacromial impingement syndrome(SIS) and healthy volunteers. Methods: Fifty-eight patients with totally 65 shoulders diagnosed with SIS and 50 healthy volunteers were recruited. Ultrasound of the shoulders was performed in all participants using four standard static views(both short-axis view and long-axis view of the supraspinatus tendon and the subscapularis tendon) to evaluate bursal effusion and bursal thickness. Results: The incidences of increased bursal thickness and bursal effusion were statistically higher in SIS patients than that in the controls(χ2=71.265, P<0.001; χ2=15.345, P<0.001). On static views, bursal thickness measured on the short axis view of the supraspinatus was greater than that measured on the other three views(all P<0.05). Conclusion: Increased thickness and effusion of SAB in SIS patients can be accurately detected by ultrasound, and bursal thickness can be measured on the short axis view of the can supraspinatus simplely and accurately.