Abstract:Objective To investigate the applicability of arthroscopic and 3.0T MRI findings of anterior glenohumeral instability.Methods The MRI and arthroscopic data of 45 patients with anterior instability of glenohumeral joints was collected.MRI findings and outcomes of multi-angle lens arthroscopic surgery were retrospectively analyzed and compared.The types and degrees of injuries were summarized.Kappa test was used to analyze the consistency between MRI and arthroscopy.The diagnostic results and sensitivity of MRI were observed.Results Glenoid labrum injury accounted for 84.4% (38/45) of cases of anterior glenohumeral instability,of which the anterior lower glenoid labrum injury accounted for 51.1% (23/45).Glenoid labrum injury combined with Hill-sachs injury and joint capsule injury accounted for about 44.2%(20/45),while glenoid labrum injury combined with bony Bankart injury made up about 17.7% (8/45).According to 3.0T MRI diagnosis,the sensitivities of anterior lower glenoid labrum injury,HAGL lesion,and Hill-sachs lesion were 78.2%,71.0%,and 90.0%,respectively.According to MRI and arthroscopy diagnosis,the consistency between glenoid labrum injury,HAGL lesion and Hill-sachs lesion was good.The results of diagnosis of musculus subscapularis and tendon injury and bony Bankart injury were completely consistent,but the consistency of diagnosis of SLAP injury was not so good.Conclusions 3.0T MRI can accurately display the common lesions and MRI signs of anterior glenohumeral instability,and provide reliable data for early clinical diagnosis and treatment.
裴守科, 夏兆云, 杨乐. 盂肱关节前方不稳MR表现与关节镜手术所见比较[J]. 武警医学, 2020, 31(11): 979-982.
PEI Shouke, XIA Zhaoyun, YANG Le. Comparative study of MR findings and arthroscopy for common diseases of anterior glenohumeral instability. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(11): 979-982.
Steinbach L S.MRI of shoulder instability[J].Eur J Radiol,2008,68(1):57-71.
[11]
Grinsven S,Kesselring F O,Wassenaer H N,et al.MR arthrography of traumatic anterior shoulder lesions showed modest reproducibility and accuracy when evaluated under clinical circumstances[J].Arch Orthop Trauma Surg,2007,127(1):11-17.
[12]
Waldt S,Burkart A,Imhoff A B,et al.Anterior shoulder instability:accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries[J].Radiology,2005,237(2):578-583.
[13]
Burkhart S S,Cole B J.Bankart repair[J].Orthopedics,2012,35(2):136-137.
[14]
Andrews J R,Carson W J,Meleod W.Glenoid labrum tears related to the long head of the biceps[J].Am J Sports Med,1985,13:337-341.
[15]
Mohana A V,Chung C B,Resnick D.Superior labral anteroposterior tear:classififi cation and diagnosis on MRI and MR arthrography[J].AJR Am J Roentgenol,2003,181(6):1449-1462.