粘连性肩关节囊炎与喙肱韧带的MRI研究*

MRI study on relationship between adhesive capsulitis of shoulder and coracohumeral ligament*

摘要:

目的 利用磁共振成像（MRI）研究粘连性肩关节囊炎与喙肱韧带的关系。方法 选取2018年1月— 2019年1月昆明市第一人民医院经临床确诊为粘连性肩关节囊炎患者90例作为粘连性肩关节囊炎组（AC组），根据其临床分期分为3期；同期临床确诊为肩袖损伤患者53例作为肩痛组；50例未有任何临床症状的健康者作为对照组。各研究组均行肩关节MRI检查，测量各组喙肱韧带的厚度，并进行统计学分析。结果 3组喙肱韧带厚度比较，差异有统计学意义（P?<0.05），AC组喙肱韧带增厚；肩痛组与对照组喙肱韧带厚度比较，差异无有统计学意义（P?>0.05）。AC组3个临床分期喙肱韧带厚度比较，差异无统计学意义（P?>0.05）。AC组、肩痛组、对照组喙肱韧带厚度性别、左右肩侧比较，差异无统计学意义（P?>0.05）。结论 MRI是显示喙肱韧带较好的检查方法，增厚的喙肱韧带（3.61?mm）高度提示粘连性肩关节囊炎，这可能是粘连性肩关节囊炎是典型的磁共振表现之一；增厚的喙肱韧带对粘连性肩关节囊炎的临床分期诊断无意义。

Abstract:

Objective To explore the relationship between adhesive capsulitis of the shoulder (AC) and coracohumeral ligament (CHL) by MRI. Methods From January 2018 to January 2019 at our hospital, 90 patients with adhesive capsulitis divided into three study groups, according to its clinical stage. Fifty-three patients with rotator cuff injury were selected as painful shoulders group, and 50 healthy people as control group. The thickness of CHL was measured and compared in the each groups after MR scans of shoulder joints. Results The average thickness of the CHL was significantly greater in AC group (3.61?mm) than that in the painful shoulders group (1.81?mm) and control group (1.73?mm) (P??0.05). Significant CHL thickness difference was not showed among three clinical stages in AC group (P?>?0.05). No significant difference was found not only between the female and the male in each three groups, but between left and right shoulders (P?>?0.05). Conclusion Magnetic resonance imaging is a good method to show the coracohumeral ligament. Thickened coracohumeral ligament (3.61 mm) highly suggests adhesive capsulitis, which may be one of the typical magnetic resonance manifestations. Thickened CHL has no significance in clinical staging diagnosis of AC.