Exploration of the Optimal Display Orientation of MR Plain and Arthrographic Images of Rotator Cuff Interstitial Structures
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摘要:
目的 探讨肩袖间隙（RI）结构的磁共振（MR）平扫和关节造影最佳显示方位。 方法 选取2021年1月至2023年3月于红河州第一人民医院行MR平扫及关节造影的患者80例，均经肩关节镜手术证实RI正常。统计MR平扫及关节造影检查横轴位、斜矢状位及斜冠状位显示RI及上盂肱韧带（SGHL）、肱二头肌长头腱（LHBT）、喙肱韧带（CHL）的情况。 结果 MR斜矢状位平扫对RI结构的显示率17.50%高于横轴位0.00%、斜冠状位5.00%（4/80）（χ2 = 18.739，P < 0.001）；MR斜矢状位平扫对RI内SGHL、LHBT、CHL的显示情况优于横轴位、斜冠状位（χ2 = 26.036，P < 0.001）；MR斜矢状位关节造影对RI结构的显示率57.50%高于横轴位5.00%、斜冠状位17.50%（χ2 = 61.534，P < 0.001）；MR斜矢状位关节造影对RI内SGHL、LHBT、CHL结构的显示情况优于横轴位、斜冠状位（χ2 = 64.569，P < 0.001）；MR斜矢状位关节造影对RI结构的完全显示率57.50%明显高于MR斜矢状位平扫17.50%（χ2 = 27.307，P < 0.05）。 结论 斜矢状位是MR平扫及关节造影显示RI结构的最优显示方位，其中斜矢状位MR关节造影可作为RI结构的最佳检查方法。 Abstract:Objective To investigate the optimal display orientation of rotator cuff space（RI） structures on magnetic resonance（MR） scanning and arthrography. Methods A total of 80 patients who underwent MR scanning and arthrography in our hospital from January 2021 to March 2023 were selected and all of them were confirmed to have normal RI by shoulder arthroscopy. The RI and the superior glenohumeral ligament（SGHL）, the long head of biceps tendon（LHBT）, and the coracohumeral ligament（CHL） in the transverse axial, oblique sagittal, and oblique coronal positions were counted in the transverse axial, oblique sagittal, and oblique coronal positions on MR scanning and arthrography. Results The display rate of RI structure by oblique sagittal scan was 17.50% higher than that by horizontal scan, 0.00% and oblique coronal scan, 5.00%（4/80）（χ2 = 18.739, P < 0.001）. The display of SGHL, LHBT and CHL in RI by MR Oblique sagittal scan was better than that in transverse axis and oblique coronal scan（χ2 = 26.036, P < 0.001）. MR oblique sagittal arthrography showed a higher rate of RI structures 57.50% than transverse axial 5.00% and oblique coronal 17.50%（χ2 = 61.534, P < 0.001）; MR oblique sagittal arthrography showed better display of SGHL, LHBT, and CHL structures in RI than transverse axial and oblique coronal（χ2 = 64.569, P < 0.001）; MR oblique sagittal arthrography had a significantly higher rate of complete visualization of RI structures in 57.50% than MR oblique sagittal plain scanning in 17.50%（χ2 = 27.307, P < 0.05）. Conclusion Oblique sagittal position is the optimal display orientation for MR scanning and arthrography to show RI structures. -
图 2 MR关节造影图像
A：MR关节造影横轴位成像；B：MR关节造影斜冠状位；C：MR关节造影斜矢状位成像。
Figure 2. MR Arthrography Images
表 1 RI结构在MR平扫中完全显示情况（$n=80 $）
Table 1. RI structure is completely displayed in MR plain scan（$n=80 $）
扫描方位 完全显示（n） 不全显示（n） 显示率（%） 横轴位 0 80 0.00 斜冠状位 4 76 5.00 斜矢状位 14 66 17.50∆# χ2 18.739 P < 0.001* *P < 0.05；与横轴位比较，∆P < 0.05；与斜冠状位比较，#P < 0.05。 
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表 2 RI内诸结构在MR平扫中显示情况（$n=80 $）
Table 2. The structures in RI in MR plain scan（$n=80 $）
扫描方位 n 显示率（%） 横轴位 LHBT 46 57.50# CHL+LHBT 20 25.00# SGHL+LHBT 14 17.50# SGHL+LHBT+CHL 0 0.00# 斜冠状位 LHBT 32 40.00∆ CHL+LHBT 34 42.50∆ SGHL+LHBT 10 12.50∆ SGHL+LHBT+CHL 4 5.00∆ 斜矢状位 LHBT 14 17.50∆# CHL+LHBT 40 50.00∆# SGHL+LHBT 12 15.00∆# SGHL+LHBT+CHL 14 17.50∆# χ2 26.036 P < 0.001* *P < 0.05；与横轴位比较，∆P < 0.05；与斜冠状位比较，#P < 0.05。
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表 3 RI结构在MR关节造影中完全显示情况（$n=80 $）
Table 3. RI structure was completely displayed in MR arthrography（$n=80 $）
扫描方位 完全显示（n） 不全显示（n） 显示率（%） 横轴位 4 76 5.00# 斜冠状位 14 66 17.50∆ 斜矢状位 46 34 57.50∆# χ2 61.534 P < 0.001* *P < 0.05；与横轴位比较，∆P < 0.05；与斜冠状位比较，#P < 0.05。
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表 4 RI内诸结构在MR关节造影中显示情况（$n=80 $）
Table 4. The structures in RI in MR arthrography（$n=80 $）
扫描方位 n 显示率（%） 横轴位 LHBT 32 40.00# CHL+LHBT 28 35.00# SGHL+LHBT 16 20.00# SGHL+LHBT+CHL 4 5.00# 斜冠状位 LHBT 12 15.00∆ CHL+LHBT 34 42.50∆ SGHL+LHBT 20 25.00∆ SGHL+LHBT+CHL 14 17.50∆ 斜矢状位 LHBT 8 10.00∆# CHL+LHBT 16 20.00∆# SGHL+LHBT 10 12.50∆# SGHL+LHBT+CHL 46 57.50∆# χ2 64.569 P < 0.001* *P < 0.05；与横轴位比较，∆P < 0.05；与斜冠状位比较，#P < 0.05。
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表 5 RI结构在MR平扫和MR斜矢状位关节造影完全显示（$n $）
Table 5. RI structure was completely displayed on MR plain scan and MR oblique sagittal arthrography（$n $）
MR关节造影 MR平扫 合计 完全显示 未完全显示 完全显示 10 36 46 未全显示 4 30 34 合计 14 66 80 χ2 27.307 P < 0.001* *P < 0.05。
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