肩关节冈上肌出口位X线摄影在肩峰下撞击综合征中的应用价值

目的:探讨肩关节冈上肌出口位X线摄影所示肩峰形态、肩峰下间隙与肩峰下撞击综合征(shoulder impingement syndrome,SIS)的相关性,总结其临床应用价值。方法:回顾性分析60例经临床证实的SIS患者的临床及影像资料,对X线摄影所示的肩峰形态及肩峰下间隙进行分型、测量,并与MRI所见进行对照,分析肩峰形态及肩峰下间隙与SIS的相关性。结果:60例患者中,肩峰平坦形(Ⅰ型)8例、弧形(Ⅱ型)10例、钩状(Ⅲ型)42例。冈上肌出口位X线摄影所示肩峰下间隙为(1.21±0.36)cm,MRI所示肩峰下间隙值为(1.10±0.18)cm,两者差异无统计学意义(P0.05)。肩袖损伤MRI分级Ⅰ级27例,Ⅱ级20例,Ⅲ级13例。肩峰下间隙值与肩袖损伤MRI分级呈正相关(P0.05)。结论:肩关节冈上肌出口位X线摄影所示肩峰形态、肩峰下间隙与SIS发生密切相关;当肩峰形态为钩状及肩峰下间隙值1cm,强烈提示SIS可能,对于无MRI的基层医院诊断SIS临床意义明显,值得临床应用。

The application of supraspinatus outlet radiographic position in shoulder impingement syndrome

Objective：To investigate the correlation among subacromial space ,acromion shape and shoulder impingement syn-drome ,and to summarize clinical application value .Methods ：The clinical and imaging data of 60 patients with SIS were collected and retrospectively reviewed .The shape of acromion and tears of rotator cuff of all patients were classified .A cromion-Humerus （A-H） distance was measured .The correlation among subacromial space ,acromion shape and shoulder impingement syndrome were presented thereafter .Results：Among 60 patients ,there were 8 of type I ,10 of typeⅡ ,42 of type Ⅲ .The cromion-Humerus （A-H） distance were （1 .21 ± 0 .36）cm in DR imaging ,compared to （1 .10 ± 0 .18）cm in MR imaging ;There was no significant difference was found in A-H distance measured with X-ray and MRI （P〉0 .05） .There were 20 of type I ,25 of typeⅡ ,15 of type Ⅲ of tears of rotator cuff .There was positive correlation between the A-H distance and class of rotator cuff （P〈0 .05） . Conclusion：There are closely relationship among subacromial space ,acromion shape and shoulder impingement syndrome;typeⅢ acromion shape and too narrow cromion-Humerus distance （〈1 cm） strongly suggests SIS .