Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Conventioinal MRI Finding in a Case of Adhesive Shoulder Capsulitis

견관절의 유착성관절낭염의 고식적 자기공명영상소견

  • 박학훈 (여수한려엑스포병원 영상의학과) ;
  • 백창희 (여수백병원 정형외과)
  • Received : 2009.06.02
  • Accepted : 2010.03.05
  • Published : 2010.07.01
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Abstract

Purpose: To evaluate the conventional magnetic resonance image findings in patients with adhesive shoulder capsulitis. Materials and Methods: The preoperative MR images of 76 patients with adhesive shoulder capsulitis that was also treated by arthroscopic capsule release. In contrast to the MR images of 25 control patients without adhesive shoulder capsulitis, the thickness and area of hyposignal intensity around the coracohumeral ligament (CHL), subcoracoidal fat, capsular thickness of the rotator interval, capsular thickness, and height of the axillary recess were measured. The existence of fluid in the axillary recess was also verified. Results: Patients with adhesive capsulitis showed a significant increase in the thickness (average 10.57 mm vs. 5.88 mm, T=8.289, p<0.001), area (average 3.49 point vs. 0.96 point Z=7.775, p< 0.001) of hyposignal intensity around CHL, and a thickened joint capsule in the rotator interval (average 5.93 mm vs. 2.15 mm, Z=6.472, p< 0.001). The thickness of the hyposignal intensity around the CHL is about 10 mm or more and has a specificity of 96%, a sensitivity of about 55% in the area of hyposignal intensity from around the CHL, Seventy-five percent or more of cases, showed a 100%, 95%, complete obliteration of the subcoracoidal fat that was 96%, and a 50% thickness of the capsule. A rotator interval of 6mm or more had a 96%, 50% for the diagnosis of adhesive capsulitis of the shoulder. The capsular thickness and maximal height of axillary recess and the presence of fluid in the axillary recess was not significant in patients with adhesive shoulder capsulitis. Conclusion: Thickening of the hyposignal intensity around the CHL, subcoracoidal fat obliteration, and capsular thickening at the rotator interval, are characteristic MRI findings in adhesive shoulder capsulitis.

목적: 견관절의 유착성관절낭염의 고식적 자기공명영상 소견을 알아보고자 하였다. 대상과 방법: 수술 전 고식적 자기공명영상을 촬영한 관절경상 유착성관절낭염 환자 76명과, 관절경상 유착성관절낭염 소견이 없는 25명을 비교평가하였다. 오구상완인대주위 저신호 병변 두께와 분포, 오구돌기하 지방, 회전근개간격의 관절막 두께, 액와요의 관절막 두께, 관절강의 상하길이, 관절액 유무를 조사하였다. 결과: 유착성관절낭염 환자군이 대조군에 비해 오구상완인대주위 저신호병변의 두께(평균 10.57 mm/5.88 mm, T=8.289, p < 0.001), 병변의 분포(평균 3.49점/0.96점 Z=7.775, p < 0.001), 회전근개간격 관절막 두께(평균 5.93 mm/2.15 mm, Z=6.472, p < 0.001)의 의미 있는 증가세를 보였다. 유착성관절낭염 진단시 오구상완인대주위 저신호병변 두께 10 mm 기준시 특이도와 민감도는 96%, 55%, 오구상완인대주위 저신호병변 분포 3점 기준시 100%, 95%, 회전근개 간격 관절막 두께 6 mm 기준시 96%, 50%이고, 오구돌기하 지방소실 시 96%, 50%였다. 유착성관절낭염의 액와요 관절막의 두께, 관절강 상하길이, 관절액 유무는 대조군에 비해 유의한 차이는 없었다. 결론: 오구상완인대주위 저신호 병변의 두께와 분포증가, 오구돌기하 지방소실, 회전근개간격관절막 두께증가는 유착성관절낭염 진단에 유용한 소견이다.

Keywords

References

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