Computerized assessment of Bankart lesions under tension with magnetic resonance arthrography
Computerized assessment of Bankart lesions under tension with magnetic resonance arthrography
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DOI：
10.1016/j.jse.2004.08.004
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发表时间：
2005-05-01
影响因子：
3
通讯作者：
Takaoka, K
中科院分区：
文献类型：
--
作者：
Ito, Y;Sakai, T;Takaoka, K
基于磁共振成像（MRI）的Bankart病变的准确解剖描述是治疗创伤后复发性盂肱关节脱位的关键。MR关节造影，即在MR成像前关节内注射稀释的钆，提高了肩关节病变检测的敏感性。肩关节的外展和外旋（ABER）对下囊袋和前盂唇韧带复合体（肩关节前部稳定的重要结构）施加动态应力。本研究旨在确定是否MR关节造影，通过使用计算机图像分析，可以更好地显示Bankart病变与肩关节在中立位或在ABER。我们评估了12例创伤性前脱位后的肩关节。用图像分析软件对MRI图像进行分析。我们比较了中立位和ABER中5个关节盂节段的3个参数：分离（前关节盂边缘和前骨膜附着之间的分离长度）、位移（前关节盂边缘和移位盂唇尖端之间的距离）和Bankart面积（由分离线、位移线和Bankart病变前面界定的面积）。MR图像显示，Bankart病变在ABER中处于张力下，在中立位时肩部松弛和多余。所有病例中，ABER的所有3个参数均大于中立位（P = .012，P = .0006和P = .012）。在ABER中，肩关节MR关节造影的计算机图像评估提供了良好的Bankart病变可视化和评价。
Accurate anatomic depiction of Bankart lesions based on magnetic resonance imaging (MRI) is crucial for the treatment of posttraumatic recurrent dislocation of the glenohumeral joint. MR arthrography, the intraarticular injection of dilute gadolinium before MR imaging, improves sensitivity in the detection of shoulder pathology. Abduction and external rotation (ABER) of the shoulder places dynamic stress on the inferior capsular pouch and anterior labroligamentous complex, important structures for anterior shoulder stability. This study sought to determine whether MR arthrography, by use of computerized image analysis, can visualize Bankart lesions better with the shoulder in the neutral position or in ABER. We evaluated 12 shoulders after traumatic anterior dislocation. The MR images were analyzed with image-analyzing software. We compared 3 parameters at 5 levels of the glenoid in the neutral position and in ABER: detachment (the length of detachment between the anterior glenoid rim and the anterior periosteal attachment), displacement (the distance between the anterior glenoid rim and the tip of the displaced labrum), and Bankart area (the area bounded by the detachment line, the displacement line, and the anterior aspect of the Bankart lesion). MR images revealed that Bankart lesions were under tension in ABER and lax and redundant with the shoulder in the neutral position. All 3 parameters were greater in ABER than in the neutral position in all cases (P = .012, P = .0006, and P = .012). Computerized image assessment of MR arthrography with the shoulder in ABER provides excellent visualization and evaluation of Bankart lesions.