Evaluation of rotator cuff is a common indication for magnetic resonance imaging(MRI) scanning of the shoulder. Conventional MRI is the most commonly used technique, while magnetic resonance(MR) arthrogra-phy is reser...Evaluation of rotator cuff is a common indication for magnetic resonance imaging(MRI) scanning of the shoulder. Conventional MRI is the most commonly used technique, while magnetic resonance(MR) arthrogra-phy is reserved for certain cases. Rotator cuff disorders are thought to be caused by a combination of internal and external mechanisms. A well-structured MRI report should comment on the relevant anatomic structures including the acromial type and orientation, the pres-ence of os acromiale, acromio-clavicular degenerative spurs and fluid in the subacromial subdeltoid bursa. In addition, specific injuries of the rotator cuff tendons and the condition of the long head of biceps should be accurately reported. The size and extent of tendon tears, tendon retraction and fatty degeneration or at-rophy of the muscles are all essential components of a surgically relevant MRI report.展开更多
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 ...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.展开更多
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 mal...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.展开更多
Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities(syrinxe...Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities(syrinxes) form within the spinal cord. Here, we report a case of neuropathic arthropathy of the shoulder secondary to syringomyelia in a 40-year-old woman. X-rays of the left shoulder revealed damage to bone and joint architecture. Blood tests indicated vitamin D deficiency and secondary hyperparathyroidism. Magnetic resonance imaging of the cervical spine showed a large syrinx from the second cervical spine to the second dorsal spine. Although neuropathic arthropathy is uncommon, it should be considered in cases of unexplained pain, discomfort, or limited range of motion of the affected joint. Symptoms related to the affected joint may precede or overshadow neurological deficits. Appropriate radiological examinations and diagnoses are imperative to prevent misdiagnosis or undetected bone and joint disorders.展开更多
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 ...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.展开更多
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....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.展开更多
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...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。展开更多
文摘Evaluation of rotator cuff is a common indication for magnetic resonance imaging(MRI) scanning of the shoulder. Conventional MRI is the most commonly used technique, while magnetic resonance(MR) arthrogra-phy is reserved for certain cases. Rotator cuff disorders are thought to be caused by a combination of internal and external mechanisms. A well-structured MRI report should comment on the relevant anatomic structures including the acromial type and orientation, the pres-ence of os acromiale, acromio-clavicular degenerative spurs and fluid in the subacromial subdeltoid bursa. In addition, specific injuries of the rotator cuff tendons and the condition of the long head of biceps should be accurately reported. The size and extent of tendon tears, tendon retraction and fatty degeneration or at-rophy of the muscles are all essential components of a surgically relevant MRI report.
文摘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.
文摘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.
文摘Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities(syrinxes) form within the spinal cord. Here, we report a case of neuropathic arthropathy of the shoulder secondary to syringomyelia in a 40-year-old woman. X-rays of the left shoulder revealed damage to bone and joint architecture. Blood tests indicated vitamin D deficiency and secondary hyperparathyroidism. Magnetic resonance imaging of the cervical spine showed a large syrinx from the second cervical spine to the second dorsal spine. Although neuropathic arthropathy is uncommon, it should be considered in cases of unexplained pain, discomfort, or limited range of motion of the affected joint. Symptoms related to the affected joint may precede or overshadow neurological deficits. Appropriate radiological examinations and diagnoses are imperative to prevent misdiagnosis or undetected bone and joint disorders.
文摘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.
文摘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.
文摘目的: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。
