Vinson Emily N, Major Nancy M, Higgins Laurence D
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Skeletal Radiol. 2007 May;36(5):405-10. doi: 10.1007/s00256-006-0250-x. Epub 2007 Jan 16.
To identify shoulder magnetic resonance imaging (MRI) findings associated with surgically proven rotator interval abnormalities.
The preoperative MRI examinations of five patients with surgically proven rotator interval (RI) lesions requiring closure were retrospectively evaluated by three musculoskeletal-trained radiologists in consensus. We assessed the structures in the RI, including the coracohumeral ligament, superior glenohumeral ligament, fat tissue, biceps tendon, and capsule for variations in size and signal alteration. In addition, we noted associated findings of rotator cuff and labral pathology.
Three of three of the MR arthrogram studies demonstrated extension of gadolinium to the cortex of the undersurface of the coracoid process compared with the control images, seen best on the sagittal oblique images. Four of five of the studies demonstrated subjective thickening of the coracohumeral ligament, and three of five of the studies demonstrated subjective thickening of the superior glenohumeral ligament. Five of five of the studies demonstrated a labral tear.
The MRI arthrogram finding of gadolinium extending to the cortex of the undersurface of the coracoid process was noted on the studies of those patients with rotator interval lesions at surgery in this series. Noting this finding-especially in the presence of a labral tear and/or thickening of the coracohumeral ligament or superior glenohumeral ligament-may be helpful in the preoperative diagnosis of rotator interval lesions.
确定与手术证实的旋转间隙异常相关的肩部磁共振成像(MRI)表现。
由三位接受过肌肉骨骼影像培训的放射科医生共同对五例经手术证实需要修复旋转间隙(RI)病变患者的术前MRI检查进行回顾性评估。我们评估了RI内的结构,包括喙肱韧带、肩胛下肌上韧带、脂肪组织、肱二头肌肌腱和关节囊的大小变化和信号改变。此外,我们还记录了肩袖和盂唇病变的相关表现。
与对照图像相比,在矢状斜位图像上显示最佳,三项MR关节造影研究中有三项显示钆剂延伸至喙突下表面皮质。五项研究中有四项显示喙肱韧带主观增厚,五项研究中有三项显示肩胛下肌上韧带主观增厚。五项研究均显示盂唇撕裂。
在本系列手术中,对有旋转间隙病变患者的研究发现,MRI关节造影显示钆剂延伸至喙突下表面皮质。注意到这一表现——尤其是在存在盂唇撕裂和/或喙肱韧带或肩胛下肌上韧带增厚的情况下——可能有助于旋转间隙病变的术前诊断。