Kim Ji Na, Kwon Soon Tae, Kim Kyung Cheon
Department of Radiology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Munwha-ro 282, Jung-gu, Daejeon, 35015, Republic of Korea.
Arch Orthop Trauma Surg. 2018 Feb;138(2):247-258. doi: 10.1007/s00402-017-2834-4. Epub 2017 Nov 11.
The purpose of this study was to investigate whether postoperative shoulder magnetic resonance imaging (MRI) findings correlate with postoperative shoulder range of motion (ROM) at about 4 months after arthroscopic rotator cuff repair (ARCR).
Signal-intensity changes of the capsule, pericapsular soft tissue at the axillary recess, and subcoracoid fat triangle, as well as the thickness of the capsule at the axillary recess and coracohumeral ligament were assessed on preoperative and postoperative MR images of 232 patients. The ROM was evaluated preoperatively and at about 4 months after ARCR.
T2 hyperintensity of the capsule, pericapsular soft tissue at the axillary recess, and signal change of the subcoracoid fat triangle were detected in 155, 107, and 89 cases, respectively, on postoperative MRI. Among these cases, 129, 98, and 69 cases, respectively, showed newly developed signal changes. The mean thicknesses of the capsule and coracohumeral ligament were 1.89 ± 0.69 and 1.64 ± 0.51 mm, respectively, on preoperative MRI and 3.74 ± 1.12 and 2.42 ± 0.56 mm, respectively, on postoperative MRI. At the 4-month follow-up, the mean external rotation (ER), internal rotation (IR), abduction, forward flexion, and extension were 77, 73, 76, 83, and 82%, respectively, of the contralateral side. Newly developed T2 hyperintensity of the capsule and pericapsular soft tissue at the axillary recess on postoperative MRI significantly correlated with the postoperative limitation of ER (p = 0.039) and IR (p = 0.020).
Newly developed signal changes of the capsule, pericapsular soft tissue at the axillary recess, and subcoracoid fat triangle were often detected on postoperative MRI at 4 months after ARCR. Furthermore, newly developed T2 hyperintensity of the capsule and pericapsular soft tissue at the axillary recess correlated with limited ROM in ER and IR at 4 months after ARCR.
本研究的目的是调查关节镜下肩袖修补术（ARCR）后约4个月时，术后肩部磁共振成像（MRI）结果与术后肩部活动范围（ROM）是否相关。
在232例患者的术前和术后MRI图像上，评估关节囊、腋窝隐窝处关节囊周围软组织、喙突下脂肪三角的信号强度变化，以及腋窝隐窝处关节囊和喙肱韧带的厚度。在术前和ARCR术后约4个月时评估ROM。
术后MRI显示，关节囊、腋窝隐窝处关节囊周围软组织T2高信号以及喙突下脂肪三角信号改变分别见于155例、107例和89例。在这些病例中，分别有129例、98例和69例出现新的信号改变。术前MRI上关节囊和喙肱韧带的平均厚度分别为1.89±0.69和1.64±0.51mm，术后MRI上分别为3.74±1.12和2.42±0.56mm。在4个月随访时，患侧平均外旋（ER）、内旋（IR）、外展、前屈和后伸分别为对侧的77%、73%、76%、83%和82%。术后MRI上关节囊和腋窝隐窝处关节囊周围软组织新出现的T2高信号与术后ER（p=0.039）和IR（p=0.020）受限显著相关。
ARCR术后4个月的术后MRI常可检测到关节囊、腋窝隐窝处关节囊周围软组织和喙突下脂肪三角新出现的信号改变。此外，关节囊和腋窝隐窝处关节囊周围软组织新出现的T2高信号与ARCR术后4个月时ER和IR的活动范围受限相关。
