磁共振成像在原发性冻结肩中的诊断价值

发布时间：2018-01-15 04:07

本文关键词：磁共振成像在原发性冻结肩中的诊断价值　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:利用磁共振成像探讨原发性冻结肩患者患肩关节的结构、信号改变,总结其常规平扫图像的特征与直接肩关节造影的表现,提高冻结肩的诊断水平,为临床诊治原发性冻结肩提供影像学指导。方法:搜集2014年11月至2016年7月期间因肩关节症状至中山市中医院就诊的患者,筛选出已接受过核磁共振检查、影像图像清晰且病例资料完整并最终得到确诊的病例,根据入选标准和排除标准,将64名患者纳入原发性冻结肩组,另外64名患者纳入对照组。由两名医学影像科医师分别对两组的磁共振成像图像独立进行回顾性分析,观察关节囊水肿征、关节囊增厚征、肩袖间隙水肿征、喙突下滑囊积液征、喙肱韧带水肿征,计算各征象检出率,同时测量、记录腋窝水平的关节囊厚度;登记两组中接受磁共振肩关节造影患者的造影剂注入量。对各项数据进行统计学分析,比较两组中各征象的检出率、关节囊厚度及造影剂注入量,对原发性冻结肩的磁共振成像表现进行总结,探讨磁共振成像在原发性冻结肩中的诊断价值。结果:1.在基线资料方面,两组性别、年龄、病程、患肩数量的差异无统计学意义(P0.05)。2.两组接受了磁共振直接肩关节造影的患者,其造影剂注入量有统计学差异(P0.05),原发性冻结肩组造影剂注入量小于对照组。3.原发性冻结肩组的关节囊水肿征(包括前上部、前下部、后下部、后上部及大范围水肿)、关节囊增厚征、肩袖间隙水肿征检出率高于对照组,两组间差异有统计学意义(P0.05);原发性冻结肩组关节囊厚度大于对照组,两组间差异有统计学意义(P0.05)。4.原发性冻结肩组与对照组间喙突下滑囊积液征、喙肱韧带水肿征检出率无统计学差异(P0.05)。结论:1.关节囊水肿征、关节囊增厚征和肩袖间隙水肿征对诊断原发性冻结肩有价值。其中,关节囊水肿征以关节囊前下部水肿和大范围水肿的表现最为常见。2.喙突下滑囊积液征、喙肱韧带水肿征对诊断原发性冻结肩无明显价值,不适合作为诊断原发性冻结肩的磁共振图像征象。3.原发性冻结肩患者肩关节囊容积较其他肩关节病症减少。
[Abstract]:Objective: to study the structure and signal changes of shoulder joint in patients with primary frozen shoulder by magnetic resonance imaging (MRI), and to summarize the features of conventional plain scan images and direct shoulder arthrography, so as to improve the diagnostic level of frozen shoulder. To provide imaging guidance for clinical diagnosis and treatment of primary frozen shoulder. Methods: from November 2014 to July 2016, we collected the patients who were admitted to the traditional Chinese Medicine Hospital of Zhongshan City from November 2014 to July 2016. 64 patients were included in the primary frozen shoulder group according to the inclusion criteria and exclusion criteria. The other 64 patients were included in the control group. The MRI images of the two groups were analyzed retrospectively by two medical imaging physicians, and the edema sign of joint capsule, thickening of joint capsule and edema sign of rotator cuff space were observed. The effusion sign and edema sign of coracohumeral ligament were used to calculate the detectable rate of each sign and measure the thickness of articular capsule at axillary level at the same time. Two groups of patients were enrolled in MRA. The data were statistically analyzed to compare the detection rate of each sign, the thickness of articular capsule and the volume of contrast media in the two groups. The MRI findings of primary frozen shoulder were summarized and the diagnostic value of MRI in primary frozen shoulder was discussed. Results: 1. In baseline data, two groups were gender, age and course of disease. There was no significant difference in the number of affected shoulder. Two groups of patients who received direct MRA had significant difference in contrast medium injection (P0.05). The volume of contrast media injection in the primary frozen shoulder group was smaller than that in the control group. 3. The edema sign of the joint capsule (including anterior upper part, anterior lower part, posterior lower part, posterior upper part and large area edema) and thickened joint capsule in the primary frozen shoulder group. The positive rate of rotator cuff edema sign was higher than that of the control group, and the difference between the two groups was statistically significant (P 0.05). The thickness of the joint capsule in the primary frozen shoulder group was greater than that in the control group, and the difference between the two groups was statistically significant (P 0.05). 4. The effusion sign of the descending coracoid process sac between the primary frozen shoulder group and the control group. There was no statistical difference in the detection rate of coracohumeral ligament edema (P 0.05). Conclusion 1. The joint capsule edema sign, the joint capsule thickening sign and the rotator cuff edema sign are valuable in the diagnosis of primary frozen shoulder. The most common manifestations of edema in the anterior and lower part of the articular capsule were edema in the lower part of the articular capsule. 2. The effusion sign of the descending coracoid process and the edema sign of the coracohumeral ligament had no obvious value in the diagnosis of primary frozen shoulder. It is not suitable for the diagnosis of primary frozen shoulder. 3. The volume of shoulder capsule in patients with primary frozen shoulder is less than that in other shoulder diseases.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R684;R445.2

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