Jeong Yeon-Seok, Yum Jae-Kwang, Park Sang-Yoon
Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea.
Clin Shoulder Elb. 2018 Dec 1;21(4):200-206. doi: 10.5397/cise.2018.21.4.200. eCollection 2018 Dec.
The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle.
Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view.
Preoperative OR at Y-shaped view was 52.28 ± 8.57 (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was 13.76 ± 10.51 (2.38-42.04), and Pearson correlation coefficient was 0.604 (=0.001). Postoperative OR at Y-shaped view was 63.77 ± 9.35 (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (=0.047).
Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.
本研究旨在通过测量冈上肌最大直径处的占有率(OR)来评估术前磁共振成像(MRI)评估的相关性。
选取仁济大学三陟白医院接受肩袖修复术且术前行MRI检查的患者作为本研究对象。在T1加权MRI上,测量Y形视图下脂肪和肌肉的OR、冠状视图上冈上肌直径最大处的OR,以及术前和术后的Goutallier分级和切线征变化。评估术后OR在症状出现至手术时间、肩袖撕裂大小、术前OR以及冈上肌最大直径处与Y形视图下测量的OR差值方面的统计学意义。
Y形视图下术前OR为52.28±8.57(32.5 - 65.3)。最大直径处与Y形视图下术前OR差值为13.76±10.51(2.38 - 42.04),Pearson相关系数为0.604(P = 0.001)。Y形视图下术后OR为63.77±9.35(37.3 - 76.1)。术前和术后Goutallier分级的Pearson相关系数为 - 0.579(P = 0.002),冈上肌最大直径处与Y形视图下术后OR差值的Pearson相关系数为 - 0.386(P = 0.047)。
对于肩袖撕裂患者的冈上肌脂肪变性,不仅应在传统的Y形视图下评估,还应在冈上肌最大直径处进行评估,以制定患者的治疗方案。