Lee Susan C, Williams Danielle, Endo Yoshimi
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, 535 East 70th street, New York, NY, 10021, USA.
Curr Rev Musculoskelet Med. 2018 Mar;11(1):92-101. doi: 10.1007/s12178-018-9463-6.
The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications.
The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months. Features of capsular thickening or subacromial-subdeltoid bursal thickening and fluid distension were found to decrease substantially in the first 6-month postoperative period. MRI and US were found to be highly comparable in the postoperative assessment of the rotator cuff, although they had a lower sensitivity for partial thickness tears. Imaging evaluation of newer techniques such as patch augmentation and superior capsular reconstruction needs to be further investigated. MRI and US are useful in the postoperative assessment of the rotator cuff, not only for evaluation of the integrity of the rotator cuff, but also for detecting hardware complications and other etiologies of shoulder pain.
本综述旨在概述目前影像学评估术后肩袖的实践情况,并回顾正常及异常术后肩袖的显著影像学表现以及术后并发症。
修复后的肩袖在磁共振成像(MRI)和超声(US)上常表现异常。近期研究表明,虽然肌腱通常会恢复正常,但它们可能在超过6个月的时间内呈现出临床上无显著意义的异常影像学表现。发现关节囊增厚或肩峰下-三角肌下滑囊增厚及积液在术后最初6个月内会大幅减轻。尽管MRI和US对部分厚度撕裂的敏感性较低,但在肩袖术后评估中二者具有高度可比性。对诸如补片增强和上关节囊重建等新技术的影像学评估需要进一步研究。MRI和US在肩袖术后评估中很有用,不仅可用于评估肩袖的完整性,还可用于检测硬件并发症及肩部疼痛的其他病因。