Chalian Majid, Soldatos Theodoros, Faridian-Aragh Neda, Andreisek Gustav, McFarland Edward G, Carrino John A, Chhabra Avneesh
Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 North Caroline Street, Room 4214, Baltimore, MD 21287, USA.
Emerg Radiol. 2011 Oct;18(5):395-402. doi: 10.1007/s10140-011-0973-4. Epub 2011 Jul 7.
The purpose of this study was to determine magnetic resonance imaging (MRI) findings relevant to synovial injury of the shoulder in patients with and without acute shoulder trauma. Three hundred and nine consecutive shoulder MRI studies (185-male, 124-female, 50 ± 15 years old) were retrospectively evaluated for findings suggestive of synovial injury including rupture and/or diverticulum of the joint capsule, bursa, and biceps tendon sheath (BTS), ganglion/synovial cyst, geyser phenomenon, and sequel of previous shoulder dislocation (Hill-Sachs deformity). Patients with one or more of these findings were included in the MR-positive group, whereas the remaining subjects were used as MR negatives. Based on their medical records, patients were also divided into trauma and non-trauma groups, and statistical analysis was performed to evaluate the association between the aforementioned MRI findings and history of shoulder trauma. Fifty-six patients were included in the MR-positive group and 253 in the MR-negative group. In MR-positive group, the incidence of capsular rupture (CR) and subacromial/subdeltoid (SASD) bursal rupture was higher in trauma patients, whereas the incidence of BTS diverticulum and ganglion cyst was higher in subjects without trauma. Significant association was found between the history of acute trauma and CR, SASD bursal rupture, BTS rupture, and Hill-Sachs deformity. In shoulder MR examination, presence of CR and/or SASD bursal rupture is strongly suggestive of acute shoulder trauma. In addition, BTS rupture and Hill-Sachs deformity are more prevalent in patients with acute shoulder trauma. The presence of these features should alert MRI readers to assess for additional trauma-related internal derangements, if a respective history has not been provided.
本研究的目的是确定与有或无急性肩部创伤患者肩部滑膜损伤相关的磁共振成像（MRI）表现。对连续309例肩部MRI检查（185例男性，124例女性，年龄50±15岁）进行回顾性评估，以寻找提示滑膜损伤的表现，包括关节囊、滑囊和肱二头肌肌腱鞘（BTS）的破裂和/或憩室、腱鞘囊肿/滑膜囊肿、喷泉现象以及既往肩关节脱位的后遗症（希尔-萨克斯畸形）。有一项或多项这些表现的患者被纳入MR阳性组，其余受试者作为MR阴性组。根据病历，患者还被分为创伤组和非创伤组，并进行统计分析以评估上述MRI表现与肩部创伤史之间的关联。MR阳性组纳入56例患者，MR阴性组纳入253例患者。在MR阳性组中，创伤患者的关节囊破裂（CR）和肩峰下/三角肌下滑囊破裂的发生率较高，而无创伤受试者的BTS憩室和腱鞘囊肿的发生率较高。发现急性创伤史与CR、肩峰下/三角肌下滑囊破裂、BTS破裂和希尔-萨克斯畸形之间存在显著关联。在肩部MR检查中，CR和/或肩峰下/三角肌下滑囊破裂强烈提示急性肩部创伤。此外，BTS破裂和希尔-萨克斯畸形在急性肩部创伤患者中更为常见。如果未提供相应病史，这些特征的出现应提醒MRI阅片者评估是否存在其他与创伤相关的内部紊乱。
