Adhesive capsulitis of the shoulder: evaluation with MR arthrography
Adhesive capsulitis of the shoulder: evaluation with MR arthrography
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DOI：
10.1007/s00330-005-0020-5
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发表时间：
2006-04-01
影响因子：
5.9
通讯作者：
Kim, JM
中科院分区：
文献类型：
--
作者：
Jung, JY;Jee, WH;Kim, JM
本研究的目的是确定磁共振（MR）关节造影术在诊断粘连性关节囊炎中的有用性。回顾性分析了 28 例患有（n=14）和不患有（n=14）粘连性关节囊炎的患者的肩部 MR 图像。分别在倾斜冠状脂肪抑制的 T1 加权图像和 T2 加权图像上评估 MR 图像的囊膜和滑膜厚度以及腋窝宽度。在斜矢状脂肪抑制 T1 加权图像上，评估旋转间隔的宽度以及间隔中是否存在异常组织。斜冠状位T2加权像上两组隐窝两侧的囊膜和滑膜厚度有显着性差异（P=0.000），而斜冠状位脂肪抑制T1加权像上肱骨方面的厚度没有显着性差异（P=0.109）。在倾斜冠状 T2 加权图像上，3 毫米厚度的截止值对粘连性关节囊炎的诊断准确性最高，其敏感性、特异性和准确性在肱骨侧分别为 79% (11/14)、100% (14/14) 和 89% (25/28)，在肱骨侧为 93% (13/14)、86% (12/14) 和 89% (25/28) 分别位于关节盂侧。两组间肩肌间隙宽度、肩肌间隙异常组织有无、腋窝隐窝宽度差异有统计学意义（P < 0.05）。在不进行脂肪抑制的情况下，在倾斜冠状 T2 加权 MR 关节造影图像上测量时，腋窝隐窝的囊和滑膜厚度大于 3 mm 是诊断粘连性囊炎的实用 MR 标准。旋转间隙中异常组织的存在表现出高敏感性，但特异性较低。
The purpose of this study was to determine the usefulness of magnetic resonance (MR) arthrography for diagnosing adhesive capsulitis. Shoulder MR images of 28 patients with (n=14) and without (n=14) adhesive capsulitis were retrospectively analyzed. MR images were assessed for capsule and synovium thickness as well as the width of the axillary recess on oblique coronal fat-suppressed T1-weighted images and T2-weighted images, respectively. On oblique sagittal fat-suppressed T1-weighted images, the width of the rotator interval and the presence of abnormal tissue in the interval were evaluated. Significant differences were found between the two groups in capsule and synovium thickness on both sides of the recess on oblique coronal T2-weighted images (P=0.000), whereas thickness on the humeral aspect showed no significant difference on oblique coronal fat-suppressed T1-weighted images (P=0.109). On oblique coronal T2-weighted images, a cut-off value of 3-mm thickness gave the highest diagnostic accuracy for adhesive capsulitis with sensitivity, specificity, and accuracy of 79% (11/14), 100% (14/14), and 89% (25/28) at the humeral side and 93% (13/14), 86% (12/14), and 89% (25/28) at the glenoid side, respectively. There were significant differences in rotator interval width, presence of abnormal tissue in the rotator interval, and axillary recess width between the two groups (P < 0.05). Thickness of capsule and synovium of the axillary recess greater than 3 mm is a practical MR criterion for diagnosing adhesive capsulitis when measured on oblique coronal T2-weighted MR arthrography images without fat suppression. The presence of abnormal tissue in the rotator interval showed high sensitivity but rather low specificity.