Chew Michael L, Giuffrè Bruno M
Radiology Department, Royal North Shore Hospital, St Leonards, NSW 2065 Australia.
Radiographics. 2005 Sep-Oct;25(5):1227-37. doi: 10.1148/rg.255045160.
Pathologic conditions of the distal biceps brachii tendon are of clinical interest, with partial and complete tears being the most common. However, the anatomy of the distal biceps brachii tendon makes imaging of the distal tendon somewhat difficult. An innovation in patient positioning for magnetic resonance (MR) imaging of the distal biceps tendon was recently described in which the patient lies prone with the arm overhead, the elbow flexed to 90 degrees , and the forearm supinated, so that the thumb points superiorly. The acronym FABS (f lexed elbow, abducted shoulder, forearm supinated) has been used to describe this position. The FABS position creates tension in the tendon and minimizes its obliquity and rotation, resulting in a "true" longitudinal view of the tendon. MR imaging and, to a lesser extent, ultrasonography are useful in visualizing the distal tendon and in detecting other pathologic conditions in the cubital fossa. Partial tears are usually characterized by enlargement and abnormal contour of the tendon, along with abnormal intratendinous signal intensity. In complete tears, there is discontinuity and, if the bicipital aponeurosis is also disrupted, retraction. Imaging with FABS positioning can complement conventional MR imaging, especially in the axial plane, in the assessment of the distal biceps tendon.
肱二头肌远端肌腱的病理状况具有临床意义,其中部分撕裂和完全撕裂最为常见。然而,肱二头肌远端肌腱的解剖结构使得对远端肌腱的成像有些困难。最近描述了一种用于肱二头肌远端肌腱磁共振(MR)成像的患者体位创新方法,即患者俯卧,手臂举过头顶,肘部弯曲至90度,前臂旋后,使拇指向上。首字母缩写词FABS(屈曲肘部、外展肩部、旋后前臂)已被用于描述此体位。FABS体位可使肌腱产生张力,并使其倾斜度和旋转最小化,从而形成肌腱的“真实”纵向视图。MR成像以及在较小程度上超声检查,对于观察远端肌腱和检测肘窝中的其他病理状况很有用。部分撕裂通常表现为肌腱增粗、轮廓异常,以及肌腱内信号强度异常。在完全撕裂时,会出现连续性中断,如果肱二头肌腱膜也受到破坏,则会出现回缩。采用FABS体位成像可补充传统MR成像,尤其是在轴向平面上,有助于评估肱二头肌远端肌腱。