本文關鍵詞：磁共振成像在原發(fā)性凍結肩中的診斷價值　出處：《廣州中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 原發(fā)性凍結肩 磁共振成像 磁共振關節(jié)造影 診斷價值

【摘要】：目的:利用磁共振成像探討原發(fā)性凍結肩患者患肩關節(jié)的結構、信號改變,總結其常規(guī)平掃圖像的特征與直接肩關節(jié)造影的表現(xiàn),提高凍結肩的診斷水平,為臨床診治原發(fā)性凍結肩提供影像學指導。方法:搜集2014年11月至2016年7月期間因肩關節(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,根據入選標準和排除標準,將64名患者納入原發(fā)性凍結肩組,另外64名患者納入對照組。由兩名醫(yī)學影像科醫(yī)師分別對兩組的磁共振成像圖像獨立進行回顧性分析,觀察關節(jié)囊水腫征、關節(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,計算各征象檢出率,同時測量、記錄腋窩水平的關節(jié)囊厚度;登記兩組中接受磁共振肩關節(jié)造影患者的造影劑注入量。對各項數(shù)據進行統(tǒng)計學分析,比較兩組中各征象的檢出率、關節(jié)囊厚度及造影劑注入量,對原發(fā)性凍結肩的磁共振成像表現(xiàn)進行總結,探討磁共振成像在原發(fā)性凍結肩中的診斷價值。結果: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)計學意義(P0.05)。2.兩組接受了磁共振直接肩關節(jié)造影的患者,其造影劑注入量有統(tǒng)計學差異(P0.05),原發(fā)性凍結肩組造影劑注入量小于對照組。3.原發(fā)性凍結肩組的關節(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)計學意義(P0.05);原發(fā)性凍結肩組關節(jié)囊厚度大于對照組,兩組間差異有統(tǒng)計學意義(P0.05)。4.原發(fā)性凍結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)計學差異(P0.05)。結論:1.關節(jié)囊水腫征、關節(jié)囊增厚征和肩袖間隙水腫征對診斷原發(fā)性凍結肩有價值。其中,關節(jié)囊水腫征以關節(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)性凍結肩無明顯價值,不適合作為診斷原發(fā)性凍結肩的磁共振圖像征象。3.原發(fā)性凍結肩患者肩關節(jié)囊容積較其他肩關節(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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R684;R445.2

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