Temporal Evolution of MRI Findings After Arthroscopic Rotator Cuff Repair
Temporal Evolution of MRI Findings After Arthroscopic Rotator Cuff Repair
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DOI：
10.2214/ajr.10.4436
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发表时间：
2010-12-01
影响因子：
5
通讯作者：
Greis, Patrick
中科院分区：
文献类型：
--
作者：
Crim, Julia;Burks, Robert;Greis, Patrick
OBJECTIVE.这篇文章的目的是评估随着时间的推移发生的变化，在修复的肩袖肌腱的MRI表现，并与MRI表现与临床outcome.Subjects和方法。对40例全层肩袖撕裂患者在术前和关节镜修复术后6周、3个月和12个月进行MRI检查。术前扫描评估撕裂的大小。术后扫描评估足印的大小，肌腱厚度，修复肌腱的信号强度和全层撕裂的存在。足印和肌腱厚度根据正常百分比从1到4分级。肌腱信号强度根据异常肌腱的长度从1到4分级。足印、肌腱厚度和肌腱信号强度的综合评分用于比较相对于完整肌腱的总体肌腱外观。Rasch分析用于将有序尺度数据转换为区间尺度数据。使用间隔量表数据，MRI结果与肩关节强度和临床结局的Constant-Murley评分相关。术后第一年发生4例复发性肌腱撕裂。术后3个月，与自体肌腱相比，肌腱出现最紊乱。36个完整肌腱中有24个在6周至3个月之间肌腱评分降低。患者的肌腱外观存在相当大的差异。MRI表现与临床结局评分无相关性。修复肌腱的MRI表现随时间而变化，但与术后1年的功能或临床结局无关。
OBJECTIVE. The purpose of this article is to assess the changes occurring over time in the MRI appearance of repaired rotator cuff tendons and to correlate MRI appearance with clinical outcomes.SUBJECTS AND METHODS. MRI examinations were performed on 40 patients with full-thickness rotator cuff tears preoperatively and at 6 weeks, 3 months, and 12 months after arthroscopic repair. Preoperative scans were assessed for size of tear. Postoperative scans were evaluated for size of footprint, tendon thickness, signal intensity of the repaired tendon, and presence of full-thickness tear. Footprint and tendon thickness were graded from 1 to 4 according to percentage of normal. Tendon signal intensity was graded from 1 to 4 on the basis of the length of abnormal tendon. A composite score of footprint, tendon thickness, and tendon signal intensity was used to compare overall tendon appearance relative to the intact tendon. Rasch analysis was used to transform ordinal scale data into interval scale data. Using interval scale data, MRI findings were correlated to shoulder strength and the Constant-Murley score of clinical outcome.RESULTS. Four recurrent tendon tears occurred during the first postoperative year. Tendons appeared most disorganized compared with native tendon 3 months after surgery. Twenty-four of 36 intact tendons showed a decreased tendon score between 6 weeks and 3 months. There was considerable variability in tendon appearance among patients. There was no correlation between MRI appearance and clinical outcome score.CONCLUSION. MRI appearance of the repaired tendon changes over time but does not correlate with function or predict clinical outcomes at 1 year after surgery.