Banas M P, Miller R J, Totterman S
Department of Orthopaedics and Radiology, University of Rochester School of Medicine, N.Y., USA.
J Shoulder Elbow Surg. 1995 Nov-Dec;4(6):454-61. doi: 10.1016/s1058-2746(05)80038-2.
One hundred consecutive magnetic resonance imaging (MRI) studies of the shoulder obtained for the purpose of evaluating rotator cuff symptoms were retrospectively reviewed to assess the relationship between acromion morphologic appearance and rotator cuff disease. The studies were reviewed simultaneously by two authors. Each cuff was assigned a tendon grade and an overall cuff score with MRI criteria previously described in the literature. A newly described "lateral acromion angle" was measured from a specified oblique coronal cut on each MRI study and was correlated with the corresponding MRI-determined rotator cuff score and supraspinatus tendon grade. Observed correlations were analyzed by using statistical methods. The average measured lateral acromion angle was 78 degrees, with a range from 64 degrees to 99 degrees. Eight shoulders had angles less than or equal to 70 degrees, and all eight of these patients were found to have full-thickness rotator cuff tears. As the lateral acromion angle decreased, a statistically significant increase in rotator cuff disease was noted (p < 0.0001). A significant correlation between increasing age and rotator cuff disease was also observed (p < 0.0001). Multiple regression analysis confirmed that both the lateral acromion angle and the age of the patient were independent predictors of rotator cuff score. Finally, although a trend was noted suggesting a correlation between acromion type (I--flat, II--curved, and III--hooked) and MRI-determined rotator cuff disease, this trend did not reach statistical significance (p = 0.12). Surgical correlation with MRI rotator cuff findings in 35 patients showed an MRI sensitivity of 100% and specificity of 83%. A statistically significant correlation between the lateral acromion angle and MRI-determined rotator cuff disease has been noted. The described angle may be a useful adjuvant in the evaluation and management of rotator cuff disease.
为评估肩袖症状而进行的连续100例肩部磁共振成像（MRI）研究进行了回顾性分析，以评估肩峰形态外观与肩袖疾病之间的关系。两位作者同时对这些研究进行了审查。根据文献中先前描述的MRI标准，为每个肩袖指定了肌腱分级和肩袖总体评分。从每个MRI研究的特定斜冠状切面测量一个新描述的“外侧肩峰角”，并将其与相应的MRI确定的肩袖评分和冈上肌腱分级相关联。使用统计方法分析观察到的相关性。测得的外侧肩峰角平均为78度，范围为64度至99度。8个肩部的角度小于或等于70度，所有这8例患者均被发现有全层肩袖撕裂。随着外侧肩峰角减小，肩袖疾病有统计学意义的增加（p<0.0001）。还观察到年龄增加与肩袖疾病之间存在显著相关性（p<0.0001）。多元回归分析证实，外侧肩峰角和患者年龄都是肩袖评分的独立预测因素。最后，尽管注意到一种趋势，提示肩峰类型（I型 - 扁平，II型 - 弯曲，III型 - 钩状）与MRI确定的肩袖疾病之间存在相关性，但这种趋势未达到统计学意义（p = 0.12）。35例患者的手术与MRI肩袖检查结果的相关性显示，MRI敏感性为100%，特异性为83%。外侧肩峰角与MRI确定的肩袖疾病之间存在统计学意义的相关性。所描述的角度可能是评估和管理肩袖疾病的有用辅助指标。
