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肱二头肌长头肌腱的锚定装置：超声解剖与病理状况

Anchoring Apparatus of Long Head of the Biceps Tendon: Ultrasonographic Anatomy and Pathologic Conditions.

作者信息

Xue Heng, Bird Stephen, Jiang Ling, Jiang Jie, Cui Ligang

机构信息

Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China.

Benson Radiology, Wayville, SA 5034, Australia.

出版信息

Diagnostics (Basel). 2022 Mar 8;12(3):659. doi: 10.3390/diagnostics12030659.

DOI:10.3390/diagnostics12030659
PMID:35328211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8947553/
Abstract

The long head of the biceps tendon (LHBT) has been recognized as an important generator of anterior shoulder pain, causing a significant reduction in the shoulder flexion range. Various tendinous and ligamentous structures form the anchoring apparatus of the LHBT along its course to maintain its appropriate location during shoulder movements, including the coracohumeral ligament (CHL), superior glenohumeral ligament (SGHL), subscapularis (SSC) tendon and supraspinatus (SSP) tendon as well as the less recognized tendons of pectoralis major (PM), latissimus dorsi (LD) and teres major (TM). Lesions of this stabilizing apparatus may lead to an instability of the LHBT, resulting in pain at the anterior shoulder. Ultrasonography (US) has been increasingly used in the assessment of shoulder injuries, including the anchoring apparatus of the LHBT. An accurate diagnosis of these injuries is often challenging, given the complex anatomy and wide spectrum of pathologies. In this review article, US anatomy and common pathologic conditions that affect the anchoring apparatus of the LHBT are discussed, including biceps pulley lesions, adhesive capsulitis, chronic pathology of SSC and SSP tendons, tears in the PM tendon and injuries to the LD and TM. Knowledge of a normal anatomy, an appropriate scanning technique and US findings of common pathologic conditions are the keys to accurate diagnoses.

摘要

肱二头肌长头肌腱（LHBT）已被公认为是引起肩部前方疼痛的重要原因，会导致肩部屈曲范围显著减小。各种肌腱和韧带结构在LHBT走行过程中形成其锚定装置，以在肩部运动期间维持其适当位置，包括喙肱韧带（CHL）、肩胛上盂肱韧带（SGHL）、肩胛下肌（SSC）肌腱和冈上肌（SSP）肌腱，以及不太为人所知的胸大肌（PM）、背阔肌（LD）和大圆肌（TM）肌腱。该稳定装置的损伤可能导致LHBT不稳定，从而引起肩部前方疼痛。超声检查（US）已越来越多地用于评估肩部损伤，包括LHBT的锚定装置。鉴于解剖结构复杂且病理情况多样，对这些损伤进行准确诊断往往具有挑战性。在这篇综述文章中，将讨论US解剖结构以及影响LHBT锚定装置的常见病理状况，包括肱二头肌滑车损伤、粘连性关节囊炎、SSC和SSP肌腱的慢性病变、PM肌腱撕裂以及LD和TM损伤。了解正常解剖结构、合适的扫描技术以及常见病理状况的US表现是准确诊断的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2638/8947553/abb2666ea9a7/diagnostics-12-00659-g011.jpg
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