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关节镜下肩袖修复术后肩部肌肉连续体积变化的三维截面测量方法

Three-dimensional sectional measurement approach for serial volume changes in shoulder muscles after arthroscopic rotator cuff repair.

作者信息

Nagawa Keita, Hara Yuki, Shimizu Hirokazu, Matsuura Koichiro, Inoue Kaiji, Kozawa Eito, Sakaguchi Katsunobu, Niitsu Mamoru

机构信息

Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan.

Department of Orthopaedic Surgery, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan.

出版信息

Eur J Radiol Open. 2024 Jun 12;13:100577. doi: 10.1016/j.ejro.2024.100577. eCollection 2024 Dec.

Abstract

PURPOSE

This study assessed the serial volume changes in multiple shoulder muscles simultaneously following arthroscopic rotator cuff repair (ARCR) by a three-dimensional (3D) modeling-based sectional measurement. These volume changes were correlated with background preoperative factors.

METHODS

Four consecutive magnetic resonance imaging scans (preoperatively and postoperatively at 3, 6, and 12 months) of 33 shoulders from 31 patients who underwent arthroscopic rotator cuff repair were examined. We focused on the sectional volume differences of the supraspinatus, infraspinatus, teres minor, and subscapularis between preoperatively and 3 months postoperatively (Dif.pre.3mo) and between 3 and 12 months postoperatively (Dif.3.12mo). The correlation between volume differences and clinical/demographic parameters was determined by a multivariate analysis.

RESULTS

No statistically significant differences were observed for most serial changes in the shoulder muscle volumes. The tear-site muscles (supraspinatus and infraspinatus) showed similar tendencies for volume changes, whereas the non-tear-site muscles (teres minor and subscapularis) differed. A negative correlation was observed between Dif.pre.3mo and Dif.3.12mo for the supraspinatus, infraspinatus, and teres minor. These perioperative volume differences might correlate with tear size and symptom duration in the supraspinatus, as well as with a history of steroid injections and work and sports activity levels in the infraspinatus and teres minor.

CONCLUSION

The serial volume changes in multiple shoulder muscles after ARCR measured using our 3D sectional approach exhibited different tendencies and clinical implications depending on the primary and non-primary site of tears. Our method may serve as a potential indicator to facilitate muscle recovery and prevent the progression of postoperative muscle atrophy.

摘要

目的

本研究通过基于三维(3D)建模的断层测量,评估关节镜下肩袖修复术(ARCR)后多块肩部肌肉的连续体积变化。这些体积变化与术前背景因素相关。

方法

对31例接受关节镜下肩袖修复术的33个肩部进行连续四次磁共振成像扫描(术前、术后3个月、6个月和12个月)。我们重点关注术前与术后3个月之间(Dif.pre.3mo)以及术后3个月与12个月之间(Dif.3.12mo)冈上肌、冈下肌、小圆肌和肩胛下肌的断层体积差异。通过多变量分析确定体积差异与临床/人口统计学参数之间的相关性。

结果

肩部肌肉体积的大多数连续变化未观察到统计学上的显著差异。撕裂部位的肌肉(冈上肌和冈下肌)显示出相似的体积变化趋势,而非撕裂部位的肌肉(小圆肌和肩胛下肌)则不同。冈上肌、冈下肌和小圆肌的Dif.pre.3mo与Dif.3.12mo之间呈负相关。这些围手术期体积差异可能与冈上肌的撕裂大小和症状持续时间相关,也与冈下肌和小圆肌的类固醇注射史、工作及运动活动水平相关。

结论

使用我们的3D断层方法测量的ARCR后多块肩部肌肉的连续体积变化,根据撕裂的主要和非主要部位表现出不同的趋势和临床意义。我们的方法可能作为一种潜在指标,以促进肌肉恢复并防止术后肌肉萎缩的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97be/11223084/129fc8922b40/ga1.jpg

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