肩关节MRI喙-肱间距与喙突下撞击综合征的相关性

目的:探讨MR图像上肩关节喙-肱间距(CHI)的测量方法及其在喙突下撞击综合征(CIS)临床诊断中的应用价值。方法:回顾性分析经临床确诊的105例CIS患者的临床和MRI资料。患者年龄32~90岁,平均(57.63±10.83)岁。将CIS患者分为2组,青年组(年龄≤55岁)45例共46个肩关节中老年组(年龄>55岁)59例59个肩关节。另选取20例健康志愿者作为正常对照组,年龄22~34岁,平均(26.80±3.62)岁。分别在横轴面抑脂质子加权像和斜矢状面T₁WI上测量CHI,分析CHI与CIS的相关性。结果:青年组中,横轴面图像上CHI为4.46~9.97 mm,平均(6.63±1.05)mm;斜矢状面图像上为4.27~12.07 mm,平均(7.62±1.17)mm。中老年组,横轴面图像上CHI为1.58~9.60,平均(6.23±1.79)mm;斜矢状面图像上为3.38~10.66 mm,平均(7.17±1.89)mm。对照组中,横轴面图像上CHI为7.30~12.28 mm,平均(9.63±1.45)mm;斜矢状面图像上CHI为7.43~13.67 mm,平均(10.17±1.82)mm。横轴面和斜矢状面图像上,患者组的CHI均小于对照组,差异具有统计学意义(P<0.001);中老年组的CHI均小于青年组,但差异无统计学意义(P>0.05)。患者组中横轴面图像上测量的CHI小于斜矢状面图像,差异具有统计学意义(P<0.001)。结论:肩关节磁共振CHI的测量可以诊断CIS。

Analysis of correlation between coraco-humeral interval and subcoracoid impingement syndrome using magnetic resonance imaging

Objective:The goal of this study was to investigate the characteristics and measurement methods of coraco-humoral interval(CHI)of shoulder joint on MR images,and to analyze its application value in the diagnosis of subcoracoid impingement syndrome(CIS).Methods:The clinical and MRI data of 105 patients with clinically diagnosed CHI were retrospectively analyzed.All the patients were divided into two groups:young group of 46 shoulders in 45 cases(≤55 years)and middle to old age group of 59 shoulders(>55 years).20 healthy volunteers with age of 22 to 34 yearsmean:(26.80±3.62)years]were enrolled as the control group.The CHI on axial fat-suppressed proton density weighted images(FS-PDWI)and sagittal T₁WI was measured and recorded,respectively.The correlation between CHI and CIS was analyzed statistically.Results:In the young group,the CHI on transverse and oblique sagittal images was 4.46~9.97mm with mean of(6.63±1.05)mm and 4.27~12.07mm with mean of(7.62±1.17)mm,respectively;and in the middle-old aged group,the CHI was 1.58~9.60mm with mean of(6.23±1.79)mm and 3.38~10.66mm with mean of(7.17±1.89)mm;in the control group,the CHI was 7.30~12.28mm with mean of(9.63±1.45)mm and 7.43~13.67mm with mean of(10.17±1.82)mm.In the patients with CIS,the CHIs on the transverse and oblique sagittal images in the young group were both smaller than those of the middle-old age group,but no difference was found between the two groups(both P>0.05).The CHI of CIS patients on transverse was smaller than that on oblique sagittal images with significant difference(P<0.001).Conclusion:The coracohumeral interval measured on MRI can be used in the diagnosis of subcoracoid impingement syndrome.