Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea, College of Medicine, International ST. Mary's Hospital, Incheon, Republic of Korea.
Pain Res Manag. 2019 May 7;2019:9301970. doi: 10.1155/2019/9301970. eCollection 2019.
Thickened inferior glenohumeral ligament (IGHL) is considered as one of the major morphological parameters of adhesive capsulitis (AC). Previous studies reported that the anterior band of inferior glenohumeral ligament thickness (aIGHLT) is correlated with shoulder capsular contracture, luxatio erecta humeri, and AC. However, the thickness varies from the measured angle. To reduce this measurement error, we devised a new morphological parameter, called the anterior band of inferior glenohumeral ligament area (aIGHLA).
The aIGHL samples were collected from 54 patients with AC and from 50 control subjects who underwent shoulder magnetic resonance imaging (MRI) without any evidence of AC. Coronal T2-weighted MRI images were obtained at the shoulder level from each patient. We measured the aIGHLA and aIGHLT at the maximal view of the IGHL in the coronal plane using our picture archiving and communication system. The aIGHLA was measured at the whole cross-sectional area of the IGHL in the most hypertrophied segment of the coronal MR images. The aIGHLT was measured at the thickest point of the IGHL.
The average aIGHLA was 55.58 ± 14.16 mm in the control group and 83.71 ± 28.45 mm in the AC group. The average aIGHLT was 3.47 ± 0.99 mm in the control group and 4.52 ± 1.02 mm in the AC group. AC patients showed significantly greater aIGHLA ( < 0.001) and aIGHLT ( < 0.001) than control subjects. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off score of the aIGHLA was 63.37 mm, with 79.6% sensitivity, 80.0% specificity, and AUC of 0.84 (95% CI, 0.76-0.92). The optimal cut-off point of the IGHLT was 3.81 mm, with 74.1% sensitivity, 74.0% specificity, and AUC of 0.77 (95% CI, 0.68-0.86).
Although the aIGHLA and aIGHLT were both significantly associated with AC, the aIGHLA was a more sensitive diagnostic parameter.
增厚的下盂肱韧带（IGHL）被认为是粘连性肩关节囊炎（AC）的主要形态学参数之一。先前的研究报告称，下盂肱韧带前束厚度（aIGHLT）与肩袖囊挛缩、肱骨头直立脱位和 AC 相关。然而，厚度会因测量角度的不同而变化。为了减少这种测量误差，我们设计了一种新的形态学参数，称为下盂肱韧带前束面积（aIGHLA）。
从 54 例 AC 患者和 50 例接受肩部磁共振成像（MRI）检查且无 AC 证据的对照组患者中采集 aIGHL 样本。对每位患者在肩部水平获得冠状 T2 加权 MRI 图像。我们使用我们的图像存档和通信系统在冠状位平面上 IGHL 的最大视野下测量 aIGHLA 和 aIGHLT。aIGHLA 在冠状位 MR 图像中最肥大段的 IGHL 整个横截面积上进行测量。aIGHLT 在 IGHL 最厚处测量。
对照组的平均 aIGHLA 为 55.58 ± 14.16mm，AC 组为 83.71 ± 28.45mm。对照组的平均 aIGHLT 为 3.47 ± 0.99mm，AC 组为 4.52 ± 1.02mm。AC 患者的 aIGHLA（<0.001）和 aIGHLT（<0.001）明显大于对照组。受试者工作特征（ROC）曲线分析显示，aIGHLA 的最佳截断值为 63.37mm，灵敏度为 79.6%，特异性为 80.0%，AUC 为 0.84（95%CI，0.76-0.92）。IGHLT 的最佳截断点为 3.81mm，灵敏度为 74.1%，特异性为 74.0%，AUC 为 0.77（95%CI，0.68-0.86）。
尽管 aIGHLA 和 aIGHLT 均与 AC 显著相关，但 aIGHLA 是一种更敏感的诊断参数。
