Kwak S M, Brown R R, Trudell D, Resnick D
Department of Radiology, Veterans Administration Medical Center, San Diego, USA.
Radiology. 1998 Aug;208(2):375-80. doi: 10.1148/radiology.208.2.9680562.
To compare neutral, external rotation, and abduction external rotation positions of the glenohumeral joint during magnetic resonance (MR) arthrography in the assessment of the joint capsule, biceps-labral complex, and glenohumeral ligaments.
MR imaging with intraarticular administration of gadopentetate dimeglumine was performed in 10 adult cadaveric glenohumeral joints. Fat-suppressed oblique coronal, oblique sagittal, and axial. T1-weighted spin-echo imaging and axial three-dimensional spoiled gradient-recalled imaging were performed with each shoulder in the neutral, external rotation, and abduction external rotation positions. Shoulders were sectioned in the planes that yielded optimal MR images. Anatomic and MR imaging findings were correlated.
The biceps-labral complex was best visualized on oblique coronal and axial images obtained in external rotation. Oblique axial abduction external rotation imaging best delineated the inferior glenohumeral ligament but did not improve assessment of the superior and middle glenohumeral ligaments in comparison with findings in neutral and external rotation.
Although MR arthrography of the glenohumeral joint clearly delineates the biceps-labral complex and glenohumeral ligaments, external rotation of the shoulder optimizes visualization of the former structures. Abduction external rotation is the best position for evaluation of the inferior glenohumeral ligament and anterior capsular attachment.
比较磁共振(MR)关节造影检查期间,盂肱关节处于中立位、外旋位及外展外旋位时,关节囊、肱二头肌-盂唇复合体及盂肱韧带的情况。
对10个成年尸体盂肱关节进行关节腔内注射钆喷酸葡胺后的MR成像检查。对每个肩关节分别在中立位、外旋位及外展外旋位进行脂肪抑制斜冠状面、斜矢状面及轴位T1加权自旋回波成像以及轴位三维扰相梯度回波成像。在能获得最佳MR图像的平面上对肩关节进行切片。将解剖学和MR成像结果进行对比。
肱二头肌-盂唇复合体在肩关节外旋位时获得的斜冠状面和轴位图像上显示最佳。与中立位和外旋位的结果相比,斜轴位外展外旋成像能最好地显示盂肱下韧带,但对盂肱上韧带和盂肱中韧带的评估并无改善。
虽然盂肱关节的MR关节造影能清晰显示肱二头肌-盂唇复合体及盂肱韧带,但肩关节外旋可优化对前者结构的显示。外展外旋位是评估盂肱下韧带及前关节囊附着情况的最佳体位。