肩关节常见疾病MRI诊断-Ⅰ演示教学.ppt

MR imaging of the common shoulder abnormalities肩关节常见疾病MRI诊断 (PartⅠ) Wang chaoyan 2013/05/27 Background 背景 Shoulder disorders mainly involve rotator cuff diseases and shoulder instability. For rotator cuff diseases, routine shoulder MR imaging as the first choice can solve most of the problems in practice. For shoulder instability and related glenoid labrum lesions, shoulder MR arthrography is the first selection for evaluation 肩关节常见病变主要为肩袖相关病变和肩关节不稳定。对于肩袖相关病变，肩关节MRI 常规扫描可作为首选；对于肩关节不稳定和盂唇病变，则一般首选肩关节MRI 造影进行评价。 常见疾病名称 Rotator cuff tendons disease肩袖肌腱病 Rotator cuff tear肩袖撕裂 Subscapularis rupture肩胛下肌断裂 Acromioclavicular joint disease肩锁关节病 The sub-acromial shoulder impingement syndrome肩峰下撞击综合征 SLAP病变（上盂唇前后向撕裂） Bankart病变 HAGL病变（盂肱下韧带肱骨部撕脱） Labrum cyst 盂唇囊肿 Adhesive capsulitis joints粘连性关节囊炎 Shoulder joint osteoarthrosis肩关节骨关节病 一、 Rotator cuff tendons disease 肩袖肌腱病 Etiology pathology 病因病理： Excessive use, lead to degeneration and tear of rotator cuff 过度使用导致肩袖的退行性变和撕裂 Most often in impingement最常继发于撞击综合征 Can occur in patients with collagen vascular disease可发生于胶原血管病患者 Can be acute, but more often repeated attacks on the basis of the already suffer from tendon disease可急性发生，但更常在已患有肌腱病的基础上反复发作 Tendon thickening, hardening; Partial or total disruption; Some tear on slippery bursa, articular surface or in the stroma肌腱增厚、硬化；部分或完全中断；部分撕裂可在滑囊面、关节面或间质中 Collagen degeneration, but there is no inflammatory cells, chronic tendon can appear in fatty infiltration胶原变性，但没有炎性细胞，慢性肌腱撕裂中可出现脂肪浸润 NEER in installment of rotator cuff tendon lesions 肩袖肌腱病变的NEER分期 Ⅰ period: rotator cuff, especially hills tendon edema and hemorrhage肩袖特别是岗上肌腱水肿和出血Tendonitis or inflammatory lesions, it is better to send in less than 25 years old young man. reversible肌腱炎或炎性病变，最好发于小于25岁的青年人,可逆. Ⅱ period: inflammation further progress and more fibrous tissue formation炎症进一步进展及更多的纤维组织形成Happens at 25～45 years old.好发于25-45岁。 Ⅲ period: rotator cuff tear.肩袖撕裂。 Often occur in more than 45 years old. 常发于45岁以上。 ☆Best locatio