【摘要】 目的基于CT三维模型分析测量喙突形态和位置,探究其与肩胛下肌腱损伤(subscapularis tendon tears,STT)的相关性。方法回顾性收集了退行性肩袖损伤关节镜术后患者和健康人肩关节影像学(CT)数据,分为肩袖损伤伴STT组(A组,28例)和不伴STT组(B组,26例),以及健康组(C组,22例)。采用Mimics软件对肩胛骨进行三维建模并对喙突及关节盂位置进行评估,测量喙突长度(length of coracoid,LC)、喙突前后间距(anteroposterior distance of coracoid,ADC)、喙突高度(height of coracoid,HC)、关节盂平面扭转角(version angle of glenoid,VAG)和关节盂平面倾斜角(inclination angle of glenoid,IAG),分析比较各组参数。结果测量结果显示,LC在A、B、C三组中分别为(21.32±3.83)mm、(18.95±2.36)mm和(17.75±2.69)mm;ADC分别为(23.52±4.04)mm、(22.83±2.37)mm和(24.03±3.65)mm;HC分别为(20.76±3.35)mm、 (23.33±2.7)mm和(22.86±3.64)mm;VAG分别为(-2.99±3.27)°、(-2.28±4.9)°和(-2.83±4.4)°;IAG分别为107.82°(101.59-112.04)°、110.19°(105.86-118.72)°和110.37°(104.9-118.02)°。A、B两组间比较:LC、HC和IAG差异有统计学意义(P<0.05),而ADC、VAG两组间差异无统计学意义(P>0.05);A、C两组间比较:LC、HC和IAG差异有统计学意义(P<0.05),而ADC、VAG两组间差异无统计学意义(P>0.05)。B、C两组间比较所有测量指标均无显著差异(P>0.05)。结论喙突越长、位置越低、肩胛盂倾斜角越小越易导致STT;ADC、VAG与STT无显著相关性。更多还原

【Abstract】 Background Subscapularis tendon tear (STT) is one of the leading causes of shoulder joint pain in middle-aged and older adults.Current studies on the mechanism of subscapularis tendon tear mainly include degeneration of the tendon itself,trauma,blood supply reduction,and subcoracoid impingement.The subcoracoid impingement is often ignored in physical examination and MRI,and it is only noticed if the patient has persistent pain or if the symptoms of anterior shoulder pain are not relieved after subacromial decompression.The commonly used method for subcoracoid impingement measurement is to measure the shortest distance from the coracoid tip to the humeral head in the axial position of MRI,the coracoid-humeral distance (CH).This measurement method is greatly affected by the projection angle or the rotation angle of the humeral head and cannot accurately reflect the position of the coracoid tip.Objective To investigate the correlation between the shape and position of the coracoid process and subscapularis tendon tear (STT).Methods We retrospectively collected the imaging data of shoulder joint of patients with degenerative rotator cuff tear after arthroscopy and healthy people.They were divided into rotator cuff tears with STT group (group A,n=28),rotator cuff tear without STT group (group B,n=26),and healthy group (group C,n=22).The Mimics software was used to establish the three-dimensional modeling of the scapula and evaluate the positions of the coracoid process and scapular glenoid.The length of the coracoid (LC),the anteroposterior distance of the coracoid (ADC),the height of the coracoid (HC),the version angle of the glenoid (VAG),and the inclination angle of the glenoid (IAG) were measured,and the parameters of each group were analyzed and compared.Result The LCs in groups A,B and C were (21.32±3.83)mm,(18.95±2.36)mm,and(17.75±2.69) mm,respectively.The ADCs in groups A,B,and C were (23.52±4.04)mm,(22.83±2.37) mm,and (24.03±3.65) mm,respectively.The HCs in groups A,B,and C were (20.76±3.35) mm,(23.33±2.7) mm,and (22.86±3.64) mm,respectively.The VAGs in groups A,B,and C were (-2.99±3.27)°,(-2.28±4.9)° and (-2.83±4.4)°,respectively.The IAGs in group A,B,and C were 107.82°(101.59-112.04)°,110.19° (105.86-118.72)° and 110.37°(104.9-118.02)°,respectively.There were significant differences in LC,HC,and IAG between group A and group B (P<0.05),but there was no significant difference in ADC and VAG between the two groups (P>0.05).There were significant differences in LC,HC,and IAG between group A and group C (P<0.05),but there was no significant difference in ADC and VAG between the two groups(P>0.05).There was no significant difference in all the measured indexes between group B and group C (P>0.05).Conclusion The longer the coracoid process,the lower the position and the smaller the inclination angle of the glenoid,the more likely it to cause subscapular tendon tears.However,the ADC and VAG are not significantly related to the subscapular tendon tears.更多还原