Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon City, Gyunggi-do, South Korea, 170 Jomaru-ro, Bucheon 14584, Republic of Korea.
Curr Med Imaging. 2023;19(12):1476-1486. doi: 10.2174/1573405619666230123141247.
To identify MRI findings for injuries to periarticular soft tissue structures that were related to isolated greater tubercle fracture.
16 patients (mean age: 53.8, range 30-71 yrs) were enrolled and diagnosed with isolated greater tubercle (GT) fracture with CT and MRI and underwent shoulder arthroscopy from September 2009 to April 2019. Two musculoskeletal radiologists were blinded to the patient history and arthroscopic surgical findings and reviewed patient's CT and MRI. Fracture displacement, fracture center, and presence of bony Bankart lesion with Hill sachs lesion were checked on shoulder CT. Soft tissue injuries, including rotator cuff injury, deltoid muscle injury, long head of biceps tendon injury, capsular injury, glenoid injury, and injury location of the subscapularis and infraspinatus were checked on shoulder MRI.
MRI showed supraspinatus injury (56.3%), subscapularis injury (56.3%), deltoid muscle injury (25%), infraspinatus injury (25%), teres minor muscle injury (37.5%), injury of the long head of the biceps tendon (43.8%), inferior glenohumeral ligament tear (87.5%), superior labral anterior-toposterior lesion (25%), Bankart lesion (18.8%), and Hill-Sachs lesion (6.3%). 88.9% of subscapularis injuries and 75% of infraspinatus injuries showed caudal predominance. All of the patients with infraspinatus injuries showed concomitant teres minor muscle injuries. In order of frequency, the fracture centers were anterior (25%), posterior (31.3%), and all (43.8%). For patients with Bankart and Hill- Sachs lesions, the fracture center included the posterior portion in all cases.
MRI and active arthroscopic examinations may be valuable when an isolated GT avulsion fracture is identified on X-ray examination.
确定与孤立性大结节骨折相关的关节周围软组织损伤的 MRI 表现。
本研究共纳入 16 名（平均年龄 53.8 岁，范围 30-71 岁）患者，均经 CT 和 MRI 诊断为孤立性大结节（GT）骨折，并于 2009 年 9 月至 2019 年 4 月期间接受了肩关节镜检查。2 名肌肉骨骼放射科医生在不了解患者病史和关节镜手术结果的情况下，对患者的 CT 和 MRI 进行了评估。在肩部 CT 上检查了骨折移位、骨折中心以及是否存在 Bankart 骨损伤伴 Hill-sachs 骨损伤。在肩部 MRI 上检查了包括肩袖损伤、三角肌损伤、肱二头肌长头肌腱损伤、肩袖囊损伤、盂肱关节损伤以及肩胛下肌和冈下肌损伤部位在内的软组织损伤。
MRI 显示肩袖损伤（56.3%）、肩胛下肌损伤（56.3%）、三角肌损伤（25%）、冈下肌损伤（25%）、小圆肌损伤（37.5%）、肱二头肌长头肌腱损伤（43.8%）、下盂肱韧带撕裂（87.5%）、前上盂唇复合体损伤（25%）、Bankart 损伤（18.8%）和 Hill-Sachs 损伤（6.3%）。88.9%的肩胛下肌损伤和 75%的冈下肌损伤呈尾侧优势。所有伴有冈下肌损伤的患者均伴有小圆肌损伤。按频率顺序，骨折中心位于前侧（25%）、后侧（31.3%）和全部（43.8%）。对于伴有 Bankart 和 Hill-Sachs 损伤的患者，所有病例的骨折中心均包括后侧部分。
当 X 线检查发现孤立性 GT 撕脱骨折时，MRI 和主动关节镜检查可能具有重要价值。
