Neumann C H, Holt R G, Steinbach L S, Jahnke A H, Petersen S A
San Francisco Magnetic Resonance Center, CA 94118.
AJR Am J Roentgenol. 1992 Jun;158(6):1281-7. doi: 10.2214/ajr.158.6.1590124.
MR imaging has been shown to be accurate in the diagnosis of rotator cuff disruption and tear. Uncertainty remains about the significance of increased signal intensity in the critical zone of the supraspinatus tendon without visible disruption of tendon fibers and about the significance of other secondary findings commonly encountered with rotator cuff abnormalities, such as musculotendinous retraction or obliteration and fluid in the subacromial space. We evaluated proton density-weighted and T2-weighted coronal images (obtained on a 1.5-T superconductive MR imager) of 55 shoulders in 32 asymptomatic volunteers for signal intensity in the supraspinatus tendon, location of the musculotendinous junction, fluid in the subacromial-subdeltoid space, and appearance of the fat plane. In 89% of shoulders, the supraspinatus tendon showed focal, linear, or diffuse increased signal intensity with or without loss of the low-signal-intensity tendon margin on proton density-weighted images. None of these findings were confirmed on T2-weighted images. The musculotendinous junction was always located within an area 15 degrees medial to 30 degrees lateral to the highest point (12 o'clock) on the humeral head convexity. A peribursal fat plane was poorly defined or absent in 49%, and fluid in the subacromial-subdeltoid space was found in 20%. Increased signal intensity in the supraspinatus tendon on proton density-weighted images without a corresponding increase on T2-weighted images, the presence of small amounts of fluid in the subacromial space, and the lack of preservation of the subdeltoid fat plane are common findings in asymptomatic shoulders and by themselves are poor predictors of rotator cuff disease.
磁共振成像（MR成像）已被证明在诊断肩袖撕裂和断裂方面具有准确性。然而，对于冈上肌腱关键区域信号强度增加但肌腱纤维无明显断裂的意义，以及肩袖异常常见的其他次要表现（如肌腱肌肉回缩或消失、肩峰下间隙积液）的意义，仍存在不确定性。我们评估了32名无症状志愿者的55个肩部的质子密度加权和T2加权冠状位图像（在1.5-T超导MR成像仪上获取），以观察冈上肌腱的信号强度、肌腱肌肉交界处的位置、肩峰下 - 三角肌下间隙的积液情况以及脂肪平面的外观。在89%的肩部中，质子密度加权图像上冈上肌腱显示局灶性、线性或弥漫性信号强度增加，伴或不伴有低信号强度的肌腱边缘消失。这些表现均未在T2加权图像上得到证实。肌腱肌肉交界处始终位于肱骨头凸面最高点（12点）内侧15度至外侧30度的区域内。49%的肩部滑囊周围脂肪平面界定不清或缺失，20%的肩部发现肩峰下 - 三角肌下间隙有积液。质子密度加权图像上冈上肌腱信号强度增加而T2加权图像上无相应增加、肩峰下间隙存在少量积液以及三角肌下脂肪平面未保留，这些在无症状肩部中是常见表现，仅凭这些表现很难预测肩袖疾病。
