Department of Radiology, University of Utah, 30 N 1900 E, #1A71, Salt Lake City, UT 84103, USA.
AJR Am J Roentgenol. 2010 Dec;195(6):1361-6. doi: 10.2214/AJR.10.4436.
The purpose of this article is to assess the changes occurring over time in the MRI appearance of repaired rotator cuff tendons and to correlate MRI appearance with clinical outcomes.
MRI examinations were performed on 40 patients with full-thickness rotator cuff tears preoperatively and at 6 weeks, 3 months, and 12 months after arthroscopic repair. Preoperative scans were assessed for size of tear. Postoperative scans were evaluated for size of footprint, tendon thickness, signal intensity of the repaired tendon, and presence of full-thickness tear. Footprint and tendon thickness were graded from 1 to 4 according to percentage of normal. Tendon signal intensity was graded from 1 to 4 on the basis of the length of abnormal tendon. A composite score of footprint, tendon thickness, and tendon signal intensity was used to compare overall tendon appearance relative to the intact tendon. Rasch analysis was used to transform ordinal scale data into interval scale data. Using interval scale data, MRI findings were correlated to shoulder strength and the Constant-Murley score of clinical outcome.
Four recurrent tendon tears occurred during the first postoperative year. Tendons appeared most disorganized compared with native tendon 3 months after surgery. Twenty-four of 36 intact tendons showed a decreased tendon score between 6 weeks and 3 months. There was considerable variability in tendon appearance among patients. There was no correlation between MRI appearance and clinical outcome score.
MRI appearance of the repaired tendon changes over time but does not correlate with function or predict clinical outcomes at 1 year after surgery.
本文旨在评估肩袖撕裂经关节镜修补术后肌腱的 MRI 表现随时间的变化，并将 MRI 表现与临床结果相关联。
对 40 例全层肩袖撕裂患者进行术前、术后 6 周、3 个月和 12 个月的 MRI 检查。术前扫描评估撕裂的大小。术后扫描评估足印、肌腱厚度、修复肌腱的信号强度以及全层撕裂的存在。根据正常肌腱的百分比，足印和肌腱厚度按 1 到 4 级进行分级。根据异常肌腱的长度，肌腱信号强度按 1 到 4 级分级。采用足印、肌腱厚度和肌腱信号强度的综合评分，比较与完整肌腱相比的整体肌腱外观。Rasch 分析用于将有序尺度数据转换为区间尺度数据。使用区间尺度数据，将 MRI 发现与肩部力量和临床结果的 Constant-Murley 评分相关联。
术后第一年有 4 例肌腱再次撕裂。与正常肌腱相比，术后 3 个月时肌腱的结构最紊乱。36 根完整肌腱中有 24 根在 6 周和 3 个月之间的肌腱评分降低。患者之间的肌腱外观存在很大差异。MRI 表现与临床结果评分之间没有相关性。
修复后的肌腱 MRI 表现随时间变化，但与功能无关，也不能预测术后 1 年的临床结果。
