Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.
Radiology. 2010 Sep;256(3):870-8. doi: 10.1148/radiol.10091671.
To assess the pain course after intraarticular injection of a gadolinium-containing contrast material admixed with anesthetic for magnetic resonance (MR) arthrography of the shoulder in relation to internal derangements of the shoulder.
Institutional review board approval and informed consent were obtained for this study. The study sample consisted of 655 consecutive patients (249 female, 406 male; median age, 54 years) referred for MR arthrography of the shoulder. Pain level was measured at baseline, directly after intraarticular injection of the gadolinium-containing contrast material admixed with anesthetic, 4 hours after injection, 1 day (18-30 hours) after injection, and 1 week (6-8 days) after injection with a visual analog scale (range, 0-10). MR arthrography was used to assess the following internal derangements: lesions of the rotator cuff tendons and long biceps tendon, adhesive capsulitis (frozen shoulder), fluid in the subacromial bursa, labral tears, and osteoarthritis of the glenohumeral joint. History of shoulder surgery was recorded. Linear regression models were calculated for the dependent variable (difference between follow-up pain and baseline pain), with the independent variable grouping adjusted for age and sex.
There was no significant association between pain level over time and internal derangements of the shoulder, nor was there significant association between pain level over time in patients with a history of shoulder surgery and patients without a history of shoulder surgery.
Neither internal derangements nor prior surgery have an apparent effect on the pain course after MR arthrography of the shoulder.
评估在肩磁共振（MR）关节造影术中关节内注射含钆对比剂与麻醉剂后疼痛的过程与肩内部紊乱的关系。
本研究获得了机构审查委员会的批准和患者的知情同意。研究样本包括 655 例连续患者（女 249 例，男 406 例；中位年龄 54 岁），因肩 MR 关节造影而就诊。疼痛程度在基线时、关节内注射含钆对比剂与麻醉剂后直接测量、注射后 4 小时、1 天（18-30 小时）和 1 周（6-8 天）时用视觉模拟评分法（范围为 0-10）进行测量。MR 关节造影用于评估以下内部紊乱：肩袖肌腱和长二头肌肌腱病变、粘连性肩关节囊炎（冻结肩）、肩峰下囊积液、盂唇撕裂和盂肱关节骨关节炎。记录了肩手术史。对于因变量（随访疼痛与基线疼痛之间的差异），使用线性回归模型进行计算，独立变量分组根据年龄和性别进行调整。
疼痛程度随时间的变化与肩内部紊乱之间没有显著的相关性，也没有显著的相关性在有肩手术史的患者和没有肩手术史的患者之间疼痛程度随时间的变化。
肩内部紊乱或既往手术对肩 MR 关节造影后疼痛过程没有明显影响。
