本文關(guān)鍵詞：磁共振成像在原發(fā)性凍結(jié)肩中的診斷價(jià)值　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 原發(fā)性凍結(jié)肩 磁共振成像 磁共振關(guān)節(jié)造影 診斷價(jià)值

【摘要】：目的:利用磁共振成像探討原發(fā)性凍結(jié)肩患者患肩關(guān)節(jié)的結(jié)構(gòu)、信號改變,總結(jié)其常規(guī)平掃圖像的特征與直接肩關(guān)節(jié)造影的表現(xiàn),提高凍結(jié)肩的診斷水平,為臨床診治原發(fā)性凍結(jié)肩提供影像學(xué)指導(dǎo)。方法:搜集2014年11月至2016年7月期間因肩關(guān)節(jié)癥狀至中山市中醫(yī)院就診的患者,篩選出已接受過核磁共振檢查、影像圖像清晰且病例資料完整并最終得到確診的病例,根據(jù)入選標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn),將64名患者納入原發(fā)性凍結(jié)肩組,另外64名患者納入對照組。由兩名醫(yī)學(xué)影像科醫(yī)師分別對兩組的磁共振成像圖像獨(dú)立進(jìn)行回顧性分析,觀察關(guān)節(jié)囊水腫征、關(guān)節(jié)囊增厚征、肩袖間隙水腫征、喙突下滑囊積液征、喙肱韌帶水腫征,計(jì)算各征象檢出率,同時(shí)測量、記錄腋窩水平的關(guān)節(jié)囊厚度;登記兩組中接受磁共振肩關(guān)節(jié)造影患者的造影劑注入量。對各項(xiàng)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩組中各征象的檢出率、關(guān)節(jié)囊厚度及造影劑注入量,對原發(fā)性凍結(jié)肩的磁共振成像表現(xiàn)進(jìn)行總結(jié),探討磁共振成像在原發(fā)性凍結(jié)肩中的診斷價(jià)值。結(jié)果:1.在基線資料方面,兩組性別、年齡、病程、患肩數(shù)量的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組接受了磁共振直接肩關(guān)節(jié)造影的患者,其造影劑注入量有統(tǒng)計(jì)學(xué)差異(P0.05),原發(fā)性凍結(jié)肩組造影劑注入量小于對照組。3.原發(fā)性凍結(jié)肩組的關(guān)節(jié)囊水腫征(包括前上部、前下部、后下部、后上部及大范圍水腫)、關(guān)節(jié)囊增厚征、肩袖間隙水腫征檢出率高于對照組,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05);原發(fā)性凍結(jié)肩組關(guān)節(jié)囊厚度大于對照組,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.原發(fā)性凍結(jié)肩組與對照組間喙突下滑囊積液征、喙肱韌帶水腫征檢出率無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.關(guān)節(jié)囊水腫征、關(guān)節(jié)囊增厚征和肩袖間隙水腫征對診斷原發(fā)性凍結(jié)肩有價(jià)值。其中,關(guān)節(jié)囊水腫征以關(guān)節(jié)囊前下部水腫和大范圍水腫的表現(xiàn)最為常見。2.喙突下滑囊積液征、喙肱韌帶水腫征對診斷原發(fā)性凍結(jié)肩無明顯價(jià)值,不適合作為診斷原發(fā)性凍結(jié)肩的磁共振圖像征象。3.原發(fā)性凍結(jié)肩患者肩關(guān)節(jié)囊容積較其他肩關(guān)節(jié)病癥減少。
[Abstract]:Objective: to study the structure and signal changes of shoulder joint in patients with primary frozen shoulder by magnetic resonance imaging (MRI), and to summarize the features of conventional plain scan images and direct shoulder arthrography, so as to improve the diagnostic level of frozen shoulder. To provide imaging guidance for clinical diagnosis and treatment of primary frozen shoulder. Methods: from November 2014 to July 2016, we collected the patients who were admitted to the traditional Chinese Medicine Hospital of Zhongshan City from November 2014 to July 2016. 64 patients were included in the primary frozen shoulder group according to the inclusion criteria and exclusion criteria. The other 64 patients were included in the control group. The MRI images of the two groups were analyzed retrospectively by two medical imaging physicians, and the edema sign of joint capsule, thickening of joint capsule and edema sign of rotator cuff space were observed. The effusion sign and edema sign of coracohumeral ligament were used to calculate the detectable rate of each sign and measure the thickness of articular capsule at axillary level at the same time. Two groups of patients were enrolled in MRA. The data were statistically analyzed to compare the detection rate of each sign, the thickness of articular capsule and the volume of contrast media in the two groups. The MRI findings of primary frozen shoulder were summarized and the diagnostic value of MRI in primary frozen shoulder was discussed. Results: 1. In baseline data, two groups were gender, age and course of disease. There was no significant difference in the number of affected shoulder. Two groups of patients who received direct MRA had significant difference in contrast medium injection (P0.05). The volume of contrast media injection in the primary frozen shoulder group was smaller than that in the control group. 3. The edema sign of the joint capsule (including anterior upper part, anterior lower part, posterior lower part, posterior upper part and large area edema) and thickened joint capsule in the primary frozen shoulder group. The positive rate of rotator cuff edema sign was higher than that of the control group, and the difference between the two groups was statistically significant (P 0.05). The thickness of the joint capsule in the primary frozen shoulder group was greater than that in the control group, and the difference between the two groups was statistically significant (P 0.05). 4. The effusion sign of the descending coracoid process sac between the primary frozen shoulder group and the control group. There was no statistical difference in the detection rate of coracohumeral ligament edema (P 0.05). Conclusion 1. The joint capsule edema sign, the joint capsule thickening sign and the rotator cuff edema sign are valuable in the diagnosis of primary frozen shoulder. The most common manifestations of edema in the anterior and lower part of the articular capsule were edema in the lower part of the articular capsule. 2. The effusion sign of the descending coracoid process and the edema sign of the coracohumeral ligament had no obvious value in the diagnosis of primary frozen shoulder. It is not suitable for the diagnosis of primary frozen shoulder. 3. The volume of shoulder capsule in patients with primary frozen shoulder is less than that in other shoulder diseases.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R684;R445.2

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