MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder
MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder
复制标题
MR 关节造影术，包括外展和外旋图像，用于评估肩部的非创伤性多向不稳定性
DOI：
10.1007/s00330-014-3133-x
复制
发表时间：
2014
影响因子：
5.9
通讯作者：
K. Woertler
中科院分区：
文献类型：
--
作者：
C. Schaeffeler;S. Waldt;J. Bauer;C. Kirchhoff;B. Haller;M. Schröder;E. Rummeny;A. Imhoff;K. Woertler
目的评价磁共振关节造影（MR-A）包括外展/外旋（ABER）图像评估肩部非外伤性多向不稳（MDI）囊冗余的诊断征象和测量结果。方法由3名放射科医生对20例临床诊断的MDI患者和17例无不稳定性患者的21例MR-A（包括ABER位置）进行评估。在 ABER 图像上，评估了肱骨头 (HH) 和前下盂肱韧带 (AIGHL)（新月征）之间是否存在对比度层以及 HH、AIGHL 和关节盂之间的三角形空间（三角形征）；测量了 HH 的中心。在标准成像平面上确定肩关节间隙 (RI) 前上突出和关节盂版本。结果新月征在 MDI 诊断中的敏感性为 57%/62%/48%（观察者 1/2/3），特异性为 100%/100%/94%。三角形符号的敏感性为 48%/57%/48%，特异性为 94%/94%/100%。两种迹象的组合的敏感性为 86%/90%/81%，特异性为 94%/94%/94%。正三角符号与 HH 偏心显着相关。两组之间 RI 突出、RI 宽度和关节盂的测量值没有显着差异。 结论 联合评估 ABER 位置 MR-A 上的冗余征象可以准确区分非创伤性 MDI 患者和临床稳定肩部患者；标准成像平面上的测量结果似乎不合适。要点•MR 关节造影可以准确识别无创伤性 MDI 患者。•肩部外展和外旋成像可提供附加信息。•肩关节囊肿大可通过 MR 关节造影诊断。
ObjectiveTo evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images.MethodsTwenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes.ResultsThe crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups.ConclusionsCombined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate.Key Points•MR arthrography has the possibility to accurately identify patients with atraumatic MDI.•Imaging of the shoulder in abduction and external rotation provides additive information.•Capsular enlargement of the shoulder can be diagnosed on MR arthrography.