Four-dimensional computed tomography scans facilitate preoperative planning in snapping scapula syndrome
Four-dimensional computed tomography scans facilitate preoperative planning in snapping scapula syndrome
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DOI：
10.1016/j.jse.2014.09.020
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发表时间：
2015-04-01
影响因子：
3
通讯作者：
Wijeratna, Malin D.
中科院分区：
文献类型：
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作者：
Bell, Simon N.;Troupis, John M.;Wijeratna, Malin D.
假设：由于4维CT扫描（4D CT）能够在肩胛骨弹响综合征患者中提供真实的运动3维（3D）图像，因此4D CT扫描应能够显示肩胛骨对后胸部的骨性撞击。本研究旨在确定4D CT扫描是否有助于临床医生确定肩胛骨的大小和位置，从而导致肩胛骨撞击在患者与弹响scapula syndrome.Materials and Methods：在2009年10月和2013年8月之间，12例患者（中位年龄，26.5岁;范围15-55岁）与弹响肩胛骨综合征进行了研究与4D CT。所形成的图像产生肩胛胸关节的动态体积渲染重建，显示其运动和肩胛骨对周围骨结构的任何动态撞击区域。有症状和无症状肩胛骨之间的不对称性被用来确定患者症状的放射学原因。结果：5例患者肩胛骨与胸后肋骨骨性接触，其中1例患者肩胛骨与胸后肋骨骨性接触，另1例患者肩胛骨与胸后肋骨骨性接触。4例患者显示肩胛骨与胸后肋无骨性接触，但紧密贴壁。3例患者表现出没有骨撞击，但异常运动的第二和第三肋骨所造成的软组织tethering structure.Conclusion：4D CT扫描图像定义的病理以及患者的肩胛骨和软组织引起的症状的肩胛骨综合征和改善的数量和位置的评估。(C)由Elsevier Inc.出版。代表肩肘外科杂志董事会。All rights reserved.
Hypothesis: Because a 4-dimensional CT scan (4D CT) is able to provide a moving 3-dimensional (3D) image in real time in patients with snapping scapula syndrome, a 4D CT scan should be able to demonstrate bony impingement of the scapula on the posterior thorax. This study was performed to determine if 4D CT scans aid the clinician in defining the size and location of the scapular bone causing impingement in patients with snapping scapula syndrome.Materials and methods: Between October 2009 and August 2013, 12 patients (median age, 26.5 years; range 15-55 years) with snapping scapula syndrome were investigated with 4D CT. The images formed produced a dynamic volume-rendered reconstruction of the scapulothoracic joint that displayed its movements and any dynamic area of impingement of the scapula on surrounding bony structures. Asymmetry between symptomatic and asymptomatic scapulae was used to determine the radiologic cause of the patient's symptoms. After the failure of conservative management, 8 patients underwent surgery for their condition.Results: Five patients demonstrated bony contact of the scapula on the posterior thoracic ribs. Four patients demonstrated no bony contact but close apposition of the scapula to the posterior thoracic ribs. Three patients demonstrated no bony impingement but abnormal movement of the second and third rib caused by a soft-tissue tethering structure.Conclusion: The 4D CT scan images defined pathology well in patients with snapping scapula syndrome and improved assessment of the amount and location of the scapular bone and soft tissue causing symptoms. (C) 2015 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.