Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Objective:To analyze the value of multi-slice spiral computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of carpal joint injury.Methods:A total of 130 patients with suspected wrist injuries admitted to the Department of Orthopedics of our hospital from January 2023 to January 2024 were selected and randomly divided into a single group(n=65)and a joint group(n=65).The single group was diagnosed using multi-slice spiral CT,and the joint group was diagnosed using multi-slice spiral CT and magnetic resonance imaging,with pathological diagnosis as the gold standard.The diagnostic results of both groups were compared to the gold standard,and the diagnostic energy efficiency of both groups was compared.Results:The diagnostic results of the single group compared with the gold standard were significant(P<0.05).The diagnostic results of the joint group compared with the gold standard were not significant(P>0.05).The sensitivity and accuracy of diagnosis in the joint group were significantly higher than that in the single group(P<0.05).The specificity of diagnosis in the joint group was higher as compared to that in the single group(P>0.05).Conclusion:The combination of multi-slice spiral CT and MRI was highly accurate in diagnosing wrist injuries,and the misdiagnosis rate and leakage rate were relatively low.Hence,this diagnostic program is recommended to be popularized.

Magnetic resonance imaging in glenohumeral instability

The glenohumeral joint is the most commonly dislocated joint of the body and anterior instability is the most common type of shoulder instability.Magnetic resonance (MR) imaging,and more recently,MR arthrography,have become the essential investigation modalities of glenohumeral instability,especially for pre-procedure evaluation before arthroscopic surgery.Injuries associated with glenohumeral instability are variable,and can involve the bones,the labor-ligamentous components,or the rotator cuff.Anterior instability is associated with injuries of the anterior labrum and the anterior band of the inferior glenohumeral ligament,in the form of Bankart lesion and its variants;whereas posterior instability is associated with reverse Bankart and reverse Hill-Sachs lesion.Multidirectional instability often has no labral pathology on imaging but shows specific osseous changes such as increased chondrolabral retroversion.This article reviews the relevant anatomy in brief,the MR imaging technique and the arthrographic technique,and describes the MR findings in each type of instability as well as common imaging pitfalls.

Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder's arthroscopic classification

AIM To determine diagnostic performance of magnetic resonance arthrography(MRA) in evaluating rotator cuff tears(RCTs) using Snyder's classification for reporting.METHODS One hundred and twenty-six patients(64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder's classification was recorded. MRA examinations were evaluated by two independent radiologists(14 and 5 years' experience) using Snyder's classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial-and fullthickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa statistics.RESULTS On arthroscopy, 71/126 patients(56%) had a fullthickness RCT. The remaining 55/126 patients(44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed fullthickness RCTs, 66(93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent(k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases(92%); in the remaining 5/66 cases(8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total(k = 1.000).CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder's classification for reporting. Snyder's classification may be adopted for routine reporting of MRA.

Analysis of CT and MRI in the Diagnosis of Shoulder Joint Injury

Objective: To observe the effect of multi-slice spiral CT and magnetic resonance imaging (MRI) in the diagnosis of shoulder injury. Methods: 120 patients with shoulder injury who were treated in our hospital (January 2020 to December 2021) and underwent surgical treatment were diagnosed as shoulder injury. They were divided into CT group, MRI group and joint diagnosis group. The detection rates of the two methods were compared. Results: In the diagnosis of shoulder injury, MRI group was higher than CT group, and the joint diagnosis group was higher than the other two groups. Conclusion: In the diagnosis of shoulder injury, the joint examination of multi-slice spiral CT and magnetic resonance imaging (MRI) can obtain a higher diagnostic rate and ideal effect.

High Frequency Ultrasound in Determining the Causes of Acute Shoulder Joint Pain

Shoulder ultrasonography is approved as the examination of choice for rotator cuff abnormality in many centers around the world since it is an inexpensive and safe tool for investigation of rotator cuff abnormalities. The goal of this study was to determine the ultrasound findings in patients with acute shoulder joint pain, and also to identify possible predictors of shoulder pain, as well as to compare the ultrasound diagnostic performance to that of MRI in such condition. A total of 65 (mean age 28 ± 1.2 years) consequential patients were recruited for a period of six months between July 2015 and June 2016 in this study. Collected data were confined on age, medical history, and clinical symptoms. Shoulder ultrasound was performed with a linear array transducer (10 - 15 MHz) connected to HI vision Avius ultrasound unit;Hitachi. MRI for the shoulder joint was performed in all cases to confirm the ultrasound results, using 1.5-T MRI system (Magnetom Espree);Siemens. Statistical analysis was completed using the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 20 for windows. Ultrasound manages to determine the causes of acute shoulder joint pain in 98% of the patients. Fitted achievement values for shoulder ultrasound in the diagnosis the causes of shoulder joint pain were 100% sensitivity and a range of 96% to 100% of accuracy. Ultrasound presents a high sensitivity and accuracy in diagnosis a wide spectrum of shoulder joint lesions, with a diagnostic performance near to that of MRI.

人工智能辅助压缩感知技术在肩关节MRI中的应用

目的:探讨人工智能辅助下的压缩感知(Artificial intelligence compressed sensing,ACS)技术在肩关节MRI成像中对图像质量和缩短扫描时间的应用价值。方法:招募健康志愿者27例,应用联影3.0T MR行肩关节MRI扫描,对受试者均应用并行采集技术(PI)以及ACS技术扫描肩关节横轴位PDWI、矢状位PDWI、冠状位T2WI、冠状位T1WI序列,4个序列使用PI技术的综合加速因子分别为1.77、1.72、1.60、1.87,使用ACS技术的综合加速因子分别为3.23、3.01、2.81、2.86。由两名医师从关节图像结构显示情况、脂肪抑制情况、伪影及图像整体情况四方面进行评分。在两组图像相同层面位置测量冈上肌、肱骨头均匀组织的信号强度(SI)和噪声值(SD),计算冈上肌和肱骨头SNR和CNR。采用配对样本t检验和Mann-Whitney U检验对主观评分和客观评价指标进行统计学分析。结果:PI在横轴位PDWI、矢状位PDWI、冠状位T2WI、冠状位T1WI的主观评分别为4.89±0.33、4.85±0.46、4.85±0.46、4.85±0.46,ACS为4.92±0.27、4.92±0.27、4.88±0.33、4.92±0.27,差异无统计学意义(P>0.05)。PI在横轴位PDWI、矢状位PDWI、冠状位T2WI、冠状位T1WI测量冈上肌SNR分别为25.08±4.08、30.40±6.93、10.37±1.95、17.53±3.17,低于ACS的31.77±6.83、38.95±7.05、13.22±2.47、20.09±5.95,差异有统计学意义(P<0.05)。ACS组总扫描时间为241 s,较PI组(438 s)比较,减少了45%。结论:应用ACS技术扫描肩关节MRI,可以在保证图像的质量的前提下,大幅减少扫描时间,为临床提供高效的检查。

MRI与DR在急性膝关节损伤诊断中的效能对比分析

目的:分析比较磁共振成像(MRI)与数字化X射线摄影(DR)在急性膝关节损伤诊断中的效能。方法:回顾性分析2021年1月-2023年4月梅州市第二中医医院收治的80例急性膝关节损伤患者(129膝)病例资料。以关节镜检查结果作为金标准,比较MRI与DR各单项检查以及二者联合使用在急性膝关节损伤诊断中的诊断效能。结果:DR诊断急性膝关节损伤中,半月板损伤准确度为85.27%(110/129),Kappa值为0.71;韧带损伤准确度为82.95%(107/129),Kappa值为0.64;骨骼损伤准确度为87.60%(113/129),Kappa值为0.74;MRI诊断急性膝关节损伤中,半月板损伤准确度为93.80%(121/129),Kappa值为0.88;韧带损伤准确度为87.60%(113/129),Kappa值为0.73;骨骼损伤准确度为96.12%(124/129),Kappa值为0.92;MRI联合DR诊断急性膝关节损伤中,半月板损伤准确度为95.35%(123/129),Kappa值为0.91;韧带损伤准确度为95.35%(123/129),Kappa值为0.89;骨骼损伤准确度为96.12%(124/129),Kappa值为0.92。MRI检查、联合检查诊断半月板损伤、骨骼损伤准确度均明显高于DR(P<0.05),联合检查诊断韧带损伤准确度高于MRI与DR各单项检查(P<0.05)。结论:MRI与DR在急性膝关节损伤诊断中均具有较高效能,在半月板损伤及骨骼损伤诊断方面MRI优势更高,二者联合采用能有效提高膝关节韧带损伤准确度。

脑电图联合磁共振对不同分级小儿急性胆红素脑病的诊断及预后预测价值

目的探讨脑电图联合磁共振(MRI)对不同分级小儿急性胆红素脑病(ABE)的诊断及预后预测价值。方法选取2021年1月至2023年1月在菏泽市牡丹人民医院新生儿科住院的80例ABE患儿为研究对象,均进行脑电图检测和MRI检测,计算G/P比值以及9个电极的功率谱值,采用受试者工作特征(ROC)曲线分析脑电图联合MRI对ABE的诊断及预后预测价值。结果脑电图对不同分级ABE的误诊例数为轻度5例,中度2例,重度3例;MRI对不同分级ABE的误诊例数为轻度2例,中度1例,重度1例;脑电图联合MRI对不同分级ABE的误诊例数为轻度1例。预后不良组G/P比值、O1、O2、T3、T4、C3、C4、Cz、Fp1、Fp2功率谱值均高于预后良好组(P<0.05);ROC曲线结果显示,脑电图联合MRI对ABE预后预测的曲线下面积高于单一检查。结论ABE患儿脑电图9个电极的功率谱值和MRI G/P比值变化明显,且均与临床分级和预后有关,联合检查可提高预后预测和分级诊断效能。

Investigation of the Value of Different Field Strength MRI Scans for the Diagnosis of Rotator Cuff in Juries

Objective: A comparison of the difference between the two types of field MR scan in diagnosis of shoulder joint injury. Method: Randomly selected 153 patients with arthroscopic or open arthroplasty who had shoulder pain or dysfunction treated in our hospital from 2014 to 2017 were divided into 1.5 T group and 3.0 according to the field strength of MRI examination. Postoperative pathology was a gold standard. The sensitivity, specificity, consistency, and predictive value of two field-strength MRI examinations in the diagnosis of rotator cuff tears were calculated and compared. Results: The sensitivity, specificity, crude consistency, positive predictive value, and negative predictive value of the 1.5 T group were 68.75%, 82.35%, 73.47%, 88.00%, and 58.33%, respectively. The 3.0 T group was 72.22%, 89.47%, 78.18%, 92.86% and 62.96%, the differences between the above indicators were not statistically significant (P > 0.05). Conclusion: There was no difference in the authenticity and benefit index of rotator cuff injury diagnosed by 1.5 T and 3.0 T MRI.

膝关节损伤诊断中MRI及多层螺旋CT的诊断比较分析

目的膝关节损伤诊断中磁共振成像(magnetic resonance imaging,MRI)及多层螺旋CT(Multi slice spiral CT,MSCT)的诊断比较分析。方法选取2018年10月—2022年12月江苏省启东市中医院收治的42例疑似膝关节损伤患者为研究对象,所有患者均进行MRI、MSCT检查,以综合评估诊断为金标准,对比两种检查方式诊断结果,对不同类型膝关节损伤检查符合率。结果金标准检测结果为阳性35例、阴性7例。MRI检测结果为真阳34例、假阳1例、真阴6例、假阴1例;MSCT检测结果为真阳29例、假阳6例、真阴1例、假阴6例。MRI检查的准确度、敏感度高于MSCT,差异有统计学意义(P<0.05)。MRI检查与MSCT检查的特异度比较,差异无统计学意义(P>0.05)。42例患者中,骨折18例、半月板损伤24例、关节腔积液28例、韧带损伤6例。MRI、MSCT检查方式对半月板损伤、韧带损伤检查的符合率对比,差异有统计学意义(P<0.05);MRI、MSCT检查方式对骨折、关节腔积液检查的符合率对比,差异无统计学意义(P>0.05),但MRI检出率数值均更高,为100.00%。结论相较于MSCT检查方法,MRI对膝关节损伤的诊断准确率更高。

MRI PDWI-FS序列在膝关节半月板损伤诊断和分级中的应用价值

目的探究MRI PDWI-FS序列在膝关节半月板损伤诊断和分级中的应用价值。方法选择2021年7月至2022年8月来我院就诊的膝关节半月板损伤患者132例,患者均经关节镜及MRI PDWI-FS序列检查,比较两种方式在膝关节损伤分级中的结果,并以膝关节镜为“金标准”,评估MRI PDWI-FS序列在膝关节半月板撕裂中诊断价值。结果MRIP DWIF S序列与关节镜对于膝关节损伤分级的Kappa值为0.795;以膝关节镜为“金标准”,MRI诊断膝关节半月板撕裂的灵敏度、特异度、准确率分别为92.86%、90.79%、91.67%,其中诊断内侧、外侧膝关节半月板撕裂的灵敏度、特异度、准确率分别为9655%、93.18%、94.52%和88.89%87.50%、88.14%。结论MRI PDWI-FS序列对于膝关节半月板损伤诊断及分级均有重要价值,可作为临床常规检查手段。

多层螺旋CT与磁共振成像联合诊断在肩关节损伤中的应用

目的:探讨多层螺旋CT与磁共振成像(MRI)联合诊断在肩关节损伤中的应用。方法:回顾性分析2019年5月—2022年5月盐城市亭湖区人民医院收治的90例肩关节损伤患者的影像学诊断资料,根据诊断方式的不同分为对照组与联合组,各45例。对照组采取MRI诊断,联合组采取多层螺旋CT联合MRI诊断。比较两组诊断结果与最终手术病理诊断结果的符合情况。结果:联合组肩关节骨折、肩关节软组织及诊断总符合率高于对照组,差异有统计学意义(P<0.05)。结论:多层螺旋CT与MRI联合诊断可提高肩关节损伤诊断准确率,为后续治疗方案提供更为可靠的依据。

颞下颌关节骨性关节炎患者磁共振定量形态学评估

目的探讨颞下颌关节紊乱病(temporomandibular joint disorders,TMD)患者发生颞下颌关节骨性关节炎(temporomandibular joint osteoarthrosis,TMJOA)关节窝及髁突形态学改变。方法选取我院行颞下颌关节磁共振检查的TMD患者124例,分成颞下颌关节骨性关节炎组48例(91侧关节)和无颞下颌关节骨性关节炎组76例(152侧关节),分别测量每侧颞下颌关节关节窝深度、关节窝前后径、关节窝指数、髁突内外径、髁突前后径及髁突指数,两组之间采用独立样本t检验及Mann-Whitney U检验,同时进行二元Logistic回归分析法建立回归模型,绘制受试者工作特征曲线。结果颞下颌关节骨性关节炎和无颞下颌关节骨性关节炎两组之间关节窝深度、关节窝指数、髁突前后径、髁突内外径及髁突指数差异均有统计学意义(P<0.001),二元Logistic回归分析提示关节窝深度、关节窝指数、髁突内外径及髁突前后径可以作为鉴别二者的变量,ROC曲线下面积0.89。结论TMD患者基于关节窝及髁突形态变量构建的二元Logistic回归模型,可以用于颞下颌关节骨性关节炎的预测。

肩关节前方盂唇损伤的MRI和MR关节造影诊断

目的:探讨MRI和MR关节造影在肩关节前方盂唇损伤中的诊断价值,评估MR关节造影在鉴别肩关节前方盂唇不同类型损伤中的作用。方法:自2007年1月至2010年12月,对经肩关节MRI、MR关节造影诊断后进行关节镜手术治疗的153例肩部损伤患者的临床资料进行了回顾性分析。由1位骨骼肌肉系统影像学医生和1位运动医学医生共同阅片,得出一致的MRI和MR关节造影诊断,并与关节镜下结果进行比较。计算MRI和MR关节造影诊断肩关节前方盂唇损伤的敏感性、特异性和准确性。在MR关节造影下存在前方盂唇损伤的患者中,对其不同类型损伤进行分型,与关节镜下分型进行对比研究。结果:153例中,肩关节前方盂唇损伤78例,肩袖损伤67例,上盂唇从前到后(superior labrum anterior to posterior,SLAP)损伤8例,MRI和MR关节造影诊断肩关节前方盂唇损伤的灵敏度分别为80.8%和92.3%,特异度分别为89.3%和97.3%,准确度分别为85.0%和94.8%。78例关节镜下存在肩关节前方盂唇损伤的患者中,Bankart损伤39例,前方盂唇骨膜袖套样撕脱(ALPSA)损伤32例,Perthes损伤7例,MR关节造影正确诊断Bankart、ALPSA和Perthes损伤的灵敏度分别为84.6%、84.4%和57.1%。结论:MR关节造影较MRI诊断肩关节前方盂唇损伤的灵敏度、特异度和准确度更高,MR关节造影能在术前进一步明确盂唇损伤的类型,为确定术前计划提供依据。

3.0T MR肩关节造影对肩袖损伤的诊断价值分析

目的探讨3. 0T MR肩关节造影在肩袖损伤诊断中的价值。方法回顾性分析2014年3月～2017年3月期间,经关节镜检查证实的111例肩袖损伤的肩关节术前常规MRI和MR关节造影资料。结果 111例肩关节中,肩袖完全撕裂15例,常规MRI和MR关节造影正确诊断率均为100%;肩袖部分撕裂96例,其中滑囊面型27例、肌腱内型26例、关节面型43例,常规MRI对以上三种类型的肩袖部分撕裂正确诊断率分别为85. 2%、88. 5%和76. 7%,MR关节造影对其正确诊断率分别为85. 2%、80. 8%和93. 0%;两种检查方法对滑囊面型和肌腱内型肩袖部分撕裂的诊断无明显差异,而对关节面型肩袖部分撕裂的诊断,MR关节造影优于常规MRI,差异有统计学意义(P <0. 05)。结论 MR关节造影对肩袖损伤的诊断具有较高的价值,但在关节滑囊型和肌腱内型两种类型的肩袖部分撕裂的诊断中仍存在一定的局限性。

磁共振肩关节造影在肩袖损伤的临床应用

目的探讨MRA检查对肩袖损伤的诊断价值。方法回顾性分析127例肩袖损伤MRA及MRI表现,与肩关节镜手术结果对照。结果 127例肩袖损伤病例,MRI诊断肩袖完全撕裂的敏感度、特异度及准确度分别是79.25%、82.43%和81.10%;诊断部分撕裂的敏感度、特异度及准确度分别是73.33%、67.31%和70.87%;其一致性较好(Kappa=0.708),差异均有统计学意义(P<0.05)。MRA诊断Ⅰ型8例(6.30%)、Ⅱ型21例(16.54%)、Ⅳ型32例(25.20%),其敏感度分别为100%、95.24%、96.88%;特异度分别为100%、99.06%、98.95%;准确度分别为100%、98.43%、98.43%;明显高于常规MRI诊断;与关节镜结果对比,其一致性极佳(Kappa=0.944),差异均有统计学意义(P<0.05);而对于Ⅲ型、Ⅴ型和Ⅵ型肩袖损伤,MRA均不能显示其损伤部位及程度,无法对其进行诊断。结论 MRA能准确判断Ⅰ型、Ⅱ型和Ⅳ型肩袖撕裂范围及程度,是MRI诊断肩袖损伤的有效补充,为临床诊断和治疗能提供更准确的依据。

常规磁共振与磁共振间接关节造影诊断肩袖损伤的对比研究

目的对比常规磁共振(MR)和MR间接关节造影诊断肩袖损伤的效能。方法对临床怀疑肩袖损伤的56例患者均行常规MR、MR间接关节造影检查及肩关节镜检查。以肩关节镜检查作为诊断"金标准",比较常规MR、MR间接关节造影检查对肩袖全层撕裂与部分撕裂、肌腱炎的诊断效能。结果 56例患者经关节镜检查确诊为肩袖损伤46例,其中,肩袖部分撕裂24例,全层撕裂16例,肌腱炎6例。常规MR与MR间接关节造影诊断肌腱炎的结果与关节镜检查结果一致,其诊断效能相当。常规MR与MR间接关节造影诊断肩袖部分撕裂的特异度均为95.5%,诊断全层撕裂的特异度分别为93.3%、100.0%。MR间接关节造影诊断肩袖部分撕裂的灵敏度91.7%、准确度95.7%均明显高于常规MR的37.5%、67.4%,差异有统计学意义(P<0.05)。常规MR与MR间接关节造影诊断肩袖全层撕裂的灵敏度、准确度均较好,分别为87.5%和95.7%、93.8和97.8%,两种方法灵敏度、准确度比较,差异无统计学意义(P>0.05)。结论常规MR检查和MR间接关节造影均是诊断肩袖损伤全层撕裂可靠而较为准确的检查手段;MR间接关节造影可明显提高诊断肩袖部分撕裂的灵敏度、准确度。

MR关节造影评价肩关节损伤并与关节镜对照研究

目的以关节镜诊断结果为对照,研究探讨磁共振关节造影对肩袖及关节盂唇损伤的诊断价值,以期为提高肩关节损伤的诊断准确性提供指导依据。方法收集我院就诊的120例肩关节损伤患者,所有患者均接受常规肩关节MR扫描、MR关节造影检查、肩关节镜检查,分析常规MR、MR关节造影、关节镜检查的诊断结果,以关节镜诊断结果为金标准,计算和比较常规MR、MR关节造影对肩袖损伤、盂唇损伤的诊断灵敏度、特异度、准确性,再采用Kappa一致性检验,分析常规MR、MR关节造影诊断结果与关节镜诊断结果之间的一致性。结果以关节镜诊断结果为对照,MR关节造影对肩袖损伤的诊断灵敏度、特异度、准确性分别为97.70%、96.97%、97.50%,常规MR对肩袖损伤的诊断灵敏度、特异度、准确性分别为89.66%、81.82%、87.50%;MR关节造影对盂唇损伤的诊断灵敏度、特异度、准确性分别为95.83%、97.22%、96.67%,常规MR对肩袖损伤的诊断灵敏度、特异度、准确性分别为81.25%、84.72%、83.33%;经比较,MR关节造影对肩袖损伤、盂唇损伤的诊断灵敏度、特异度、准确性均高于常规MR(P<0.05)。经一致性检验,MR关节造影对肩袖损伤、盂唇损伤的诊断结果与关节镜诊断结果之间的一致性均达到良好(Kappa分别为0.719、0.725),而常规MR对肩袖损伤、盂唇损伤的诊断结果与关节镜诊断结果之间的一致性仅为中等(Kappa分别为0.531、0.547)。结论在肩关节损伤诊断中,采用MR关节造影检查可获得与关节镜相当的诊断结果,可准确检出肩袖损伤和盂唇损伤。

3.0T MRI肩关节PROPELLER技术与常规扫描技术的对比研究

目的探讨磁共振螺旋桨采集(periodically rotated overlapping parallel lines with enhanced reconstruction,PROPELLER)技术在提高肩关节MRI图像质量、减少及消除运动伪影方面的作用。方法对79例肩关节MR扫描的患者行3.0T MRI常规FSE T2WI扫描后加扫PROPELLER FSE T2WI序列。扫描后的图像由2位诊断医师对运动伪影、呼吸伪影、血管搏动伪影、图像总体质量和冈上肌边缘进行5等级评分。常规扫描与相同方位的PROPELLER序列图像之间的对比采用Wilcoxon秩和检验。结果常规FSE T2WI扫描序列中8例因严重运动伪影无法用于诊断,而PROPELLER FSE T2WI序列图像运动伪影明显降低,评分范围3～4,平均值3.89;肩关节MR PROPELLER扫描能显著降低运动伪影、呼吸伪影及血管搏动伪影(均P<0.05),等级评分均在3级及以上;图像质量显著提高,总体评分在2级及以上(P<0.05);冈上肌边缘更加清晰、锐利。结论与肩关节常规FSE T2WI相比,PROPELLER技术能显著降低运动、呼吸及血管搏动伪影,提高图像总体质量,显示更细微的解剖结构,为临床提供更优质的诊断图像。

MRI诊断肩峰下撞击综合征

目的分析MRI征象Ⅲ型肩峰、肱肩间隙狭窄和肩袖撕裂对肩峰下撞击综合征(SAIS)的诊断价值。方法对92例肩关节MRI疑诊SAIS患者,以关节镜结果为诊断金标准,比较Ⅲ型肩峰、肱肩间隙狭窄和肩袖撕裂单一征象或联合征象诊断SAIS的效能。结果Ⅲ型肩峰、肩峰下间隙变窄、肩袖撕裂和联合征象诊断SAIS的敏感度分别为51.06%(24/47)、72.34%(34/47)、80.85%(38/47)和85.11%(40/47),单一肩袖撕裂诊断敏感度与联合征象比较差异无统计学意义(χ2=0.17,P=0.68),特异度(64.44%,29/45)低于联合征象(84.44%,38/45),差异有统计学意义(χ2=7.11,P=0.008)。结论 MRI可显示SAIS肩袖损伤、肩峰形态和最短肱肩间隙狭窄,根据以上三种征象联合诊断SAIS的效能较高。