【摘要】 目的:探讨肩关节MRI在评估肩峰小骨中的应用价值。方法:回顾性分析21例肩峰小骨的MRI资料,男性14例,女性7例;年龄29～77岁,平均年龄55.5岁。左侧12例,右侧9例。结果:21例肩峰小骨均可在轴位及斜矢状位MRI图像上清晰显示,14例可在斜冠状位MRI图像上显示。肩峰小骨在MRI图像上均表现为肩峰前部三角形或不规则形骨块,肩峰小骨与锁骨远端形成肩锁关节,与残余肩峰形成假关节,假关节位置邻近肩锁关节后部;肩峰小骨假关节间隙在T2WI图像上高信号,在T1WI图像上呈等信号。9例可见"双关节征";21例可见喙肩韧带附着于肩峰小骨前下缘;11例肩峰小骨错位;11例肩峰小骨假关节周围骨髓水肿;4例肩峰小骨假关节退行性变;17例合并肩袖损伤。结论:肩关节MRI能够很好地显示肩峰小骨并评估肩峰小骨的稳定性,轴位是显示肩峰小骨的最佳方位,"双关节征"及喙肩韧带有助于斜矢状位MRI图像上肩峰小骨的识别;肩峰小骨错位、周围骨髓水肿及假关节退行性变提示肩峰小骨的不稳定,可能与肩袖损伤有关。更多还原

【Abstract】 Objective:To explore the application value of shoulder MRI in the evaluation of os acromiale.Methods:The shoulder MRI data of 21 patients with os acromiale were retrospectively review. The patients were 14 males and 7 females, aged from 29 to 77 years old, mean aged 55.5 years old. Twelve cases were on the left shoulder and nine were right shoulder.Results:The os acromiale was best identified on axial and oblique sagittal images in all the 21 cases. Fourteen os acromiales were identified on oblique coronal images. On MRI, all the 21 os acromiales appeared as a triangular or irregular bone fragment of the distal acromion, which forms an acromioclavicular joint with distal clavicle, and also forms a pseudoarthrosis with the acromion in proximity to the acromioclavicular joint. The pseudoarthosis joint space appears as high signal intensity on T2-weighted images and low signal intensity on T1-weighted images. A “double joint” appearance was seen in 9 cases. The coracoacromial ligament was identified in all the 21 cases inserting along the anteroinferior border of the os acromiale. Os ascromiale with displacement was present in 11 cases. Marrow edema surrounding the pseudoarthosis of os acromiale was identified in 11 cases. Four cases had degenerative changes of pseudoarthosis. Seventeen cases had rotator cuff injury.Conclusion:Shoulder MRI can very well depict os acromiale and can be used to assess the stability of the os acromiale. The axial plane is best for identification of os acromiale, however, the “double joint” appearance and the coracoacromial ligament is helpful in identification of os acromaile on oblique sagittal plane. The displacement of os acromiale, marrow edema, and degenerative changes of the pseudoarthosis are indicators of the presence an unstable os acromiale, which may predispose to rotator cuff injury.更多还原