| 摘要: |
| 目的：回顾性分析冻结肩患者肩袖间隙灰阶超声和多普勒超声表现，评价超声检测肩袖间隙（rotator interval，RI）在冻结肩（Frozen shoulder，FS）中的作用。
方法：回顾性纳入2017年6月至2020年12月于我院进行肩关节超声检查并临床确诊冻结肩患者35例与肩关节不适的非冻结肩患者37例，冻结肩患者以病程6月为界，进一步分为早期组（≤6月）和中晚期组（＞6月）。分析患者肩袖间隙的超声改变，包括肩袖间隙厚度指数（rotator interval thickness index，RITI）、RI血流、喙肱韧带（Coracohumeral Ligament，CHL）厚度、喙肱韧带形态是否迂曲，进行组间比较并评价前述指标诊断冻结肩的准确性。
结果: 冻结肩组患者平均RITI为10.10±1.73mm、平均CHL厚度为3.29±0.54mm，高于非冻结肩相应指标，差异具有统计学意义（P＜0.05）。冻结肩组CHL迂曲12例（12/35，34.3%），RI血流阳性11例（11/37，31.4%），与非冻结肩组差异存在统计学意义（P＜0.05）。RITI、喙肱韧带厚度、RI血流、喙肱韧带迂曲四个指标的AUC、灵敏度、特异性依次分别为：RITI，0.794 ，0.829，0.838；喙肱韧带厚度，0.868，0.800，0.811；RI血流，0.630，0.314，0.946；喙肱韧带迂曲，0.671，0.343 ，1.000。冻结肩患者早期组与中晚期组比较，早期组患者RI血流阳性10例（10/11，90.9%），明显高于病程>6m患者的1例（1/24,4.2%），差异具有统计学意义（P＜0.05），RITI、喙肱韧带厚度、喙肱韧带迂曲差异不具有统计学意义（P＞0.05）。
结论：肩袖间隙的灰阶超声与能量多普勒评价，有助于冻结肩的诊断，其中RI血流阳性有助于病程时期判断，为临床更精准的治疗提供依据。 |
| 关键词: 超声检查，冻结肩，肩袖间隙，诊断，临床分期 |
| DOI： |
| 投稿时间：2021-04-02修订日期：2021-06-15 |
| 基金项目: |
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| The Value of Ultrasound Detection of Rotator Interval in Evaluating Frozen Shoulder |
| helijun,heyun,Qinzhebo,Chenlianxi,huaxing |
| (southwestern hospital) |
| Abstract: |
| Objective
To evaluate the role of rotator interval (RI) detection in Frozen shoulder (FS) patients by retrospectively analyzing the gray-scale and Doppler ultrasound findings.
Method
Thirty-five patients with frozen shoulder who underwent ultrasound examination and were clinically confirmed and thirty-seven non-frozen shoulder patients with shoulder discomfort in our hospital from June 2017 to December 2020 were retrospectively included. The patients with frozen shoulder were further divided into early group (≤6 months) and relatively late group (> 6 months) with the disease course of 6 months as the cut-off. Ultrasound parameters，such as rotator interval thickness index (RITI), RI blood flow, coracohumeral ligament (CHL) thickness and coracohumeral ligament tortuosity，of the shoulders were analyzed and compared between groups. Meanwhile, the accuracy of the aforementioned indicators in diagnosing frozen shoulder was accessed.
Result
The average RITI and CHL thickness in frozen shoulder group were 10.10±1.73mm and 3.29±0.54mm, which were higher than those in control group, and the difference was statistically significant (P < 0.05). There were 12 cases of CHL tortuosity (12/35, 34.3%) and 11 cases of positive RI blood flow (11/37, 31.4%) in the frozen shoulder group, which were statistically significant different from the control group (P < 0.05). Values of AUC, sensitivity and specificity of RI, coracohumeral ligament thickness, RI blood flow and coracohumeral ligament tortuosity were correspondingly as follows:0.794, 0.829 and 0.838 for RI respectively,0.868, 0.800, 0.811 for coracohumeral ligament thickness, 0.630, 0.314, 0.946 for RI blood flow and 0.671, 0.343, 1.000 for coracohumeral ligament tortuosity. Compared with the relatively late frozen shoulder group, there were 10 patients (10/11, 90.9%) with positive RI blood flow in the early group, which was significantly higher than the 1 patient (1/24,4.2%) with a course of >6M, and the difference was statistically significant (P < 0.05), while RITI, coracohumeral ligament thickness and coracohumeral ligament tortuosity were not statistically significant (P > 0.05) between them.
Conclusion
Gray-scale ultrasound and Power Doppler evaluation of RI aid in the diagnosis of frozen shoulder, and positive RI blood flow is helpful for the judgment of the disease course, providing a basis for more accurate clinical treatment. |
| Key words: Ultrasonography, frozen shoulder, rotator interval, diagnosis, clinical staging |
