MSCT和MRI在排球运动员肩关节损伤诊断中的应用

doi:10.7517/issn.1674-0475.220121

摘要/Abstract

摘要： 本文探究多层螺旋CT （MSCT）、磁共振成像（MRI）诊断排球运动员肩关节损伤的价值及与骨性结构的相关性。选取72例排球运动员肩关节损伤患者，均行MSCT、MRI检查，以关节镜检查结果作为"金标准"，比较MSCT、MRI诊断排球运动员肩关节损伤的价值及与骨性结构相关性研究。结果显示，MSCT联合MRI诊断排球运动员肩关节损伤类型的准确度高于MSCT、MRI单独诊断（P<0.05）；MSCT联合MRI诊断排球运动员肩关节损伤程度与关节镜检查结果的一致性Kappa值为0.789，准确度为87.50%；MSCT、MRI检测患侧肱骨头侧HTRA均大于健侧（P<0.05）；MSCT、MRI检测患侧肩胛盂侧IA均大于健侧，VA均小于健侧，MRI检测患侧肩胛盂侧AVCA大于健侧（P<0.05）；MRI检测患侧肩关节HAD小于健侧，ACD大于健侧（P<0.05）。MSCT联合MRI在排球运动员肩关节损伤诊断及损伤程度判定方面均具有较高准确度，其中MRI能更准确测量肩关节骨性结构变化情况。

关键词: 肩关节损伤, 排球运动员, 多层螺旋CT, 磁共振成像, 诊断, 骨性结构

Abstract: This study explored the value of multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) in the diagnosis of volleyball players' shoulder joint injuries and their correlation with bone structure. 72 cases of volleyball athletes with shoulder joint injuries were selected, and they were all examined by MSCT and MRI. The results of arthroscopy were regarded as the "gold standard" to compare the value of MSCT and MRI in diagnosing volleyball athletes' shoulder joint injuries and their correlation with bone structure. The results showed that the accuracy of MSCT combined with MRI in diagnosing the types of volleyball players' shoulder joint injuries was higher than MSCT and MRI alone (P<0.05). The Kappa value for the consistency of MSCT combined with MRI in diagnosing volleyball players' shoulder joint injury degree and arthroscopy results was 0.789, and the accuracy was 87.50%. MSCT and MRI detected HTRA on the side of the humeral head on the affected side were greater than the healthy side (P<0.05). MSCT and MRI showed that the IA of the ipsilateral scapular glenoid side was greater than that of the healthy side, while the VA was smaller than that of the healthy side. The MRI examination showed the AVCA of the ipsilateral scapular glenoid side was greater than that of the healthy side (P<0.05), the HAD of the ipsilateral shoulder joint was smaller than the healthy side, and the ACD greater than the healthy side (P<0.05). It can be seen that the combination of MSCT and MRI has a high accuracy in the diagnosis of volleyball players' shoulder joint injury and the determination of the degree of injury, and MRI can more accurately measure the changes of the bone structure for shoulder joint.

Key words: shoulder joint injury, volleyball player, multi-slice spiral CT, magnetic resonance imaging, diagnosis, bone structure

韩盼星, 王文德. MSCT和MRI在排球运动员肩关节损伤诊断中的应用[J]. 影像科学与光化学, 2022, 40(4): 757-762.

HAN Panxing, WANG Wende. Application of MSCT and MRI in the Diagnosis of Volleyball Players’ Shoulder Joint Injury[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 757-762.

参考文献

[1] 包春晖, 陈东辉. 排球运动员肩关节损伤原因及康复训练研究[J]. 当代体育科技, 2020,10(33):16-17, 21.
[2] Lesman J, Jó[XCX1.TIF] wik M, Dom[XCX2.TIF] alski M E, et al. Sport injuries in professional volleyball players[J]. Journal of Biological Regulators & Homeostatic Agents, 2020,34(4 Suppl. 3):163-170.
[3] Shih Y F, Wang Y C. Spiking kinematics in volleyball players with shoulder pain[J]. Journal of Athletic Training, 2019,54(1):90-98.
[4] 吴家莲. 排球运动肩关节损伤的原因及预防措施[J].文体用品与科技, 2020,41(12):87-88.
[5] 孙宏伟. 福建省高校排球运动员的肩关节损伤情况分析[J].宁德师范学院学报(自然科学版), 2019,31(4):414-419.
[6] 孙秋原, 李骥, 牛亚峰. 外伤性膝关节隐性骨折的核磁共振成像表现及其诊断价值分析[J]. 影像科学与光化学, 2020,38(1):138-143.
[7] 孙小煜, 宋璐, 张雪峰, 等. 应用MRI、MSCT检查在外伤性膝关节交叉韧带损伤诊治中临床价值研究[J]. 中国CT和MRI杂志, 2021,19(9):180-182.
[8] Kim D K, Park G, Kuo L T, et al. Isokinetic performance of shoulder external and internal rotators of professional volleyball athletes by different positions[J]. Scientific Reports, 2020,10(1):8706.
[9] Doherty C, Furness N D, Batten T, et al. Arthroscopy of the symptomatic shoulder arthroplasty[J]. Journal of Shoulder & Elbow Surgery, 2019,28(10):1971-1976.
[10] 王晓纯. 1.5T核磁共振成像与多层螺旋CT对肩峰下撞击综合征的诊断价值比较[J]. 影像研究与医学应用, 2021,5(2):124-125.
[11] 谭坚毅, 曾鹏程, 陶辉, 等. 多层螺旋CT与MRI联合诊断肩关节损伤的临床价值[J]. 影像研究与医学应用, 2020,4(6):198-200.
[12] 杨晓, 姜庆军, 郁冰冰, 等. MRI肩关节造影在肩袖间撕裂诊断中的临床应用价值[J]. 医学影像学杂志, 2012,22(3):502-504.
[13] 石俊岭, 崔建岭, 孙英彩, 等. 肩袖损伤患者MRI和MR肩关节造影的诊断价值比较[J]. 中国CT和MRI杂志, 2016,14(5):129-131.
[14] 丁琦峰, 王海波, 黄文亮, 等. MRI联合多层螺旋CT在腕关节损伤诊断中的应用[J]. 实用临床医学, 2019,20(2):66-67, 108.
[15] 李潇, 徐繁, 李桂萍, 等. 磁共振平扫及关节腔造影在肩关节损伤诊断的价值研究[J]. 河北医学, 2019,25(1):160-162.
[16] 张继民. 基于MSCT技术对肩关节骨性结构与肩袖损伤的相关性研究[J]. 中国CT和MRI杂志, 2018,16(9):137-140.
[17] 陈国平. MRI诊断在踝关节后方撞击综合征中的应用价值[J]. 影像研究与医学应用, 2020,4(8):211-212.
[18] Akbari-Shandiz M, Lawrence R L, Ellingson A M, et al. MRI vs CT-based 2D-3D auto-registration accuracy for quantifying shoulder motion using biplane video-radiography[J]. Journal of Biomechanics, 2019,82(1):375-380.