Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH 45267-0761, USA.
Skeletal Radiol. 2012 Sep;41(9):1105-10. doi: 10.1007/s00256-012-1366-9.
The purpose of our study was to determine if cysts in and adjacent to the lesser tuberosity are associated with rotator cuff pathology found at arthroscopy.
A retrospective review was undertaken of the magnetic resonance (MR) imaging of 286 consecutive arthroscopic procedures performed by a single orthopedic shoulder surgeon from February 2001 to June 2009. Images of the shoulders were reviewed by an experienced fellowship-trained musculoskeletal radiologist, reader 1, and a musculoskeletal fellow, reader 2, for the presence and location of lesser tuberosity cysts. Cysts were grouped by their location into those within the lesser tuberosity and those adjacent to the lesser tuberosity. Interreader agreement was calculated using kappa values.
A total of 26 patients (17 men, 9 women; age range 14–84 years; mean of 61 years) had cysts in or adjacent to the lesser tuberosity. For reader 1, patients with cysts located in the lesser tuberosity were found to be significantly older(p=00.03) and more likely to have subscapularis tendon tears(p=00.02) than patients with cysts located adjacent to the tuberosity. No significant difference in any category between patients with a cyst located in the lesser tuberosity and those adjacent to the tuberosity was identified for reader 2. Interreader agreement of imaging findings ranged from fair to near perfect agreement.
Cysts located in the lesser tuberosity at the insertion of the subscapularis tendon are suggestive of subscapularis tendon pathology and may occur in older individuals.
本研究旨在确定小结节突内和周围的囊肿是否与关节镜下发现的肩袖病变有关。
对 2001 年 2 月至 2009 年 6 月期间由同一位骨科肩关节外科医生进行的 286 例连续关节镜手术的磁共振成像（MR）进行了回顾性分析。一位经验丰富的 fellowship 培训的肌肉骨骼放射科医师（读者 1）和一位肌肉骨骼研究员（读者 2）对肩关节的图像进行了审查，以确定小结节突的存在和位置。囊肿根据其位置分为位于小结节突内和位于小结节突旁。使用 Kappa 值计算读者间的一致性。
共有 26 名患者（17 名男性，9 名女性；年龄 14-84 岁；平均 61 岁）在小结节突内或附近有囊肿。对于读者 1，位于小结节突内的囊肿患者年龄明显较大（p=00.03），并且更有可能存在肩胛下肌腱撕裂（p=00.02），而位于小结节突旁的囊肿患者则不然。读者 2 没有发现位于小结节突内的囊肿患者和位于小结节突旁的囊肿患者在任何类别之间存在显著差异。读者间影像学表现的一致性范围从公平到近乎完美的一致。
位于肩胛下肌腱插入处的小结节突内的囊肿提示肩胛下肌腱病变，可能发生在年龄较大的个体中。
