Uri D S, Kneeland J B, Dalinka M K
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, USA.
Magn Reson Q. 1995 Mar;11(1):21-44.
The shoulder is capable of the largest range motion of any articulation in the human body. Because it is inherently unstable, the glenohumeral joint is dependent on the support given by surrounding muscular, ligamentous, and tendonous structures. A variety of disorders may involve these structural supports and lead to shoulder pain and dysfunction. Refinements in magnetic resonance (MR) imaging techniques have allowed improved characterization of these abnormalities and may permit earlier and more specific diagnoses in patients with shoulder pain. Theories as to the pathogenesis of rotator cuff disease include intrinsic and extrinsic impingement as well as overload tendinosis. MR is useful in the evaluation of rotator cuff impingement and tears. The classification and MR assessment of glenohumeral instability has recently received increased attention yet remains an area of difficulty. MR arthrography has been used with some success in the evaluation of instability demonstrating improved diagnostic sensitivities and specificities when compared with conventional MR. Relatively little attention has been paid to MR evaluation of the shoulder after surgery. Micrometallic artifact, distortion of soft-tissue planes, and persistent signal abnormalities within rotator cuff and capsulolabral structures may hinder assessment of recurrent tear or instability in the postoperative patient.
肩部是人体中所有关节中活动范围最大的。由于其本质上不稳定，肱盂关节依赖于周围肌肉、韧带和肌腱结构提供的支撑。多种病症可能累及这些结构支撑并导致肩部疼痛和功能障碍。磁共振（MR）成像技术的改进使得对这些异常情况的特征描述得以改善，并且可能使肩部疼痛患者能够更早且更准确地被诊断。关于肩袖疾病发病机制的理论包括内在和外在撞击以及过载性肌腱病。MR在评估肩袖撞击和撕裂方面很有用。肱盂关节不稳定的分类和MR评估最近受到了更多关注，但仍然是一个难点领域。与传统MR相比，MR关节造影在评估不稳定方面已取得一定成功，显示出更高的诊断敏感性和特异性。术后肩部的MR评估相对较少受到关注。微金属伪影、软组织平面的扭曲以及肩袖和关节盂唇结构内持续的信号异常可能会妨碍对术后患者复发性撕裂或不稳定的评估。
