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[超声引导下肩关节磁共振关节造影关节内注射]

[Ultrasound-guided intraarticular injection for MR arthrography of the shoulder].

作者信息

Schaeffeler C, Brügel M, Waldt S, Rummeny E J, Wörtler K

机构信息

Institut für Röntgendiagnostik, Klinikum rechts der Isar der Technischen Universität München.

出版信息

Rofo. 2010 Mar;182(3):267-73. doi: 10.1055/s-0028-1109838. Epub 2009 Nov 25.

Abstract

PURPOSE

To evaluate ultrasound guidance for intraarticular contrast injection via an anterolateral approach in comparison with fluoroscopic guidance.

MATERIALS AND METHODS

Contrast agent injection was performed in 40 consecutive patients, 20 under sonographic guidance and 20 under fluoroscopic guidance. None of the patients had previous shoulder surgery. The procedure time was measured and the efficiency of joint distension, incidence of extravasation and intraarticular air on the consecutive MR arthrograms were assessed by three blinded radiologists with musculoskeletal radiology experience. Statistical analysis was performed using the Kruskal-Wallis test.

RESULTS

Intraarticular contrast injection was successfully accomplished in all 40 patients. Subsequent MR arthrograms did not show any significant difference between sonographic and fluoroscopic guidance with respect to diagnostic quality, joint distension (p=0.6665), intraarticular air bubbles (p=0.1567) and occurrence of contrast extravasation (p=0.8565). The mean duration of ultrasound-guided injection was 7:30 min compared to a shorter procedure time of 4:15 min for fluoroscopic guidance. In both groups, no procedural complications were observed.

CONCLUSION

Ultrasound-guided injection for MR arthrography of the shoulder via an anterolateral approach represents a simple, safe, and effective technique which yields comparable results to those of injection under fluoroscopic guidance, but is slightly more time-consuming.

摘要

目的

比较超声引导下经前外侧入路进行关节内造影剂注射与透视引导下的效果。

材料与方法

连续40例患者接受造影剂注射,其中20例在超声引导下进行,20例在透视引导下进行。所有患者均未接受过肩部手术。测量操作时间,并由三位具有肌肉骨骼放射学经验的盲法放射科医生评估连续MR关节造影上关节扩张的效率、外渗发生率和关节内气体情况。采用Kruskal-Wallis检验进行统计分析。

结果

40例患者均成功完成关节内造影剂注射。随后的MR关节造影显示,在诊断质量、关节扩张(p = 0.6665)、关节内气泡(p = 0.1567)和造影剂外渗发生率(p = 0.8565)方面,超声引导和透视引导之间无显著差异。超声引导注射的平均持续时间为7:30分钟,而透视引导的操作时间较短,为4:15分钟。两组均未观察到操作并发症。

结论

超声引导下经前外侧入路进行肩部MR关节造影注射是一种简单、安全、有效的技术,其结果与透视引导下注射相当,但耗时稍长。

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