All Pro Orthopedic Imaging Consultants, LLC, St Louis, MO, USA; Radsource, Brentwood, TN, USA; NYU Langone Medical Center, New York, NY, USA.
Magn Reson Imaging Clin N Am. 2020 May;28(2):285-300. doi: 10.1016/j.mric.2019.12.010. Epub 2020 Feb 17.
Muscle atrophy in shoulders with rotator cuff tendon tears is a negative prognosticator, associated with decreased function, decreased reparability, increased retears after repair, and poorer outcomes after surgery. Muscle edema or atrophy within a neurologic distribution characterizes denervation. Because most nerve entrapments around the shoulder are not caused by mass lesions and show no nerve findings on routine MR imaging sequences, pattern of muscle denervation is often the best clue to predicting location of nerve dysfunction, which narrows the differential diagnosis and guides clinical management. The exception is suprascapular nerve compression in the spinoglenoid notch caused by a compressing cyst.
肩袖肌腱撕裂导致的肩部肌肉萎缩是一个负面预后因素，与功能下降、修复能力下降、修复后再次撕裂以及手术后结果较差有关。神经支配区域内的肌肉水肿或萎缩特征为失神经支配。由于大多数肩部周围的神经卡压不是由肿块病变引起的，并且在常规磁共振成像序列上没有神经发现，因此肌肉失神经支配的模式通常是预测神经功能障碍部位的最佳线索，这缩小了鉴别诊断范围并指导了临床管理。例外情况是由压迫性囊肿引起的肩胛上神经在肩胛冈下切迹处受压。
