偏瘫性肩痛患者腋囊的MRI观测及临床意义

目的通过MRI技术观察偏瘫患者肩疼痛腋囊形态变化,为影像诊断提供依据。方法对47例偏瘫性肩疼痛患者(疼痛组)和47例正常肩部(对照组),运用MRI技术对肩关节腋囊进行测量,观察腋囊下肱盂韧带信号。结果偏瘫性肩疼痛的腋囊厚度(4.1±1.45)mm,高于对照组。腋囊腔高度(8.70±1.80)mm,腋囊腔宽度(4.31±0.56)mm,小于对照组。偏瘫性肩痛下肱盂韧带呈高信号出现率达21%,腋囊厚度与VAS呈正相关,与肩关节外展外旋呈负相关。结论脑中风中后期肩周炎是引起偏瘫性肩疼痛患者的常见原因,腋囊厚度是限制肩关节活动度的重要因素。

MRI monitoring on axillary pouch in painful hemiplegic shoulder and its clinical significance

Objective To research morphologic changes of axillary pouch in painful hemiplegic shoulder with MRI imaging technique,so as to provide evidences for imaging diagnosis.Methods 47 patients with painful hemiplegic shoulder and 47 normal individuals were involved in this study,their axillary pouches in shoulder joints were measured with MRI technology,and the signals from inferior glenohumeral ligament of axillary pouch were monitored.Results The thickness of the axillary pouch of patients with painful hemiplegic shoulder is(4.1±1.45)mm which is more than that in the control group.The height and the width of the axillary pouch is(8.70±1.80)mm and(4.31±0.56)mm respectively which is less than that in the control group.The percentage of showing high-frequent signals in the inferior glenohumeral ligament in patients with hemiplegic shoulder reaches 21%.The thickness of axillary pouch is directly proportianl to VAS,and reversely proportional to the extension and abduction of the shoulder joint.Conclusion Axillary bursitis during the midanaphase after cerebral apoplexy is the common cause incurring painful hemiplegic shoulder,and the thickness of axillary pouch is the important factor confining the flexibility of shoulder joint.