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冈上肌肌腱结合部损伤:MRI 表现及发生率。

Supraspinatus Myotendinous Junction Injuries: MRI Findings and Prevalence.

机构信息

1 Department of Radiology, Hospital Universitario Río Hortega, Valladolid, Spain.

2 Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.

出版信息

AJR Am J Roentgenol. 2019 Jan;212(1):W1-W9. doi: 10.2214/AJR.18.19776. Epub 2018 Nov 7.

Abstract

OBJECTIVE

The purpose of this study is to describe the MRI findings and evaluate the prevalence of supraspinatus myotendinous injuries.

MATERIALS AND METHODS

Among 1001 consecutive shoulders that underwent either conventional MRI or MR arthrography between January and December 2016, 843 shoulders were included. All MR images were retrospectively analyzed for identification and classification into the appropriate grade of acute or chronic rotator cuff myotendinous injuries. Other MRI findings, such as the presence of rotator cuff tendon insertional tears, and clinical information were also evaluated.

RESULTS

At MRI, 0.47% (4/843) of shoulders had supraspinatus myotendinous injuries involving the anterior muscular bundle exclusively. Chronic grade III (n = 2), acute grade III (n = 1), and acute grade II (n = 1) injuries were identified in three men and one woman (mean age, 44 years) with a clinical history of trauma (n = 2) or of progressive shoulder pain (n = 2). A concurrent supraspinatus insertional tendon tear with either partial (n = 1) or full (n = 1) thickness was present in half the cases. Loss of tension of the myotendinous junction in grade III myotendinous junction injuries led to severe atrophy and fatty infiltration of the anterior supraspinatus.

CONCLUSION

Supraspinatus myotendinous junction injuries are uncommon at MRI. These lesions invariably involve the anterior bundle of the supraspinatus muscle and may occur with a concomitant insertional tendon tear. High-grade chronic injuries lead to selective atrophy and fatty infiltration of the anterior supraspinatus muscle.

摘要

目的

本研究旨在描述 MRI 表现并评估冈上肌肌腱病损的发生率。

材料与方法

在 2016 年 1 月至 12 月间行常规 MRI 或 MRI 关节造影的 1001 例连续肩关节中,纳入 843 例肩关节。所有 MRI 图像均经回顾性分析,以识别和分类为急性或慢性肩袖肌肌腱病损的相应分级。还评估了其他 MRI 表现,如肩袖肌腱插入部撕裂的存在以及临床信息。

结果

在 MRI 上,843 例肩关节中有 0.47%(4/843)存在仅累及前肌束的冈上肌肌腱病损。3 例男性和 1 例女性(平均年龄 44 岁)存在慢性 3 级(n = 2)、急性 3 级(n = 1)和急性 2 级(n = 1)损伤,有创伤史(n = 2)或进行性肩部疼痛史(n = 2)。半数病例存在前侧冈上肌插入部肌腱撕裂,部分厚度撕裂(n = 1)或全层撕裂(n = 1)。3 级肩袖肌肌腱病损的肌腱-肌结合部张力丧失导致前侧冈上肌严重萎缩和脂肪浸润。

结论

MRI 上冈上肌肌腱结合部病损不常见。这些病变始终累及冈上肌前束,可能与插入部肌腱撕裂同时发生。慢性高级别损伤导致前侧冈上肌选择性萎缩和脂肪浸润。

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