主管：中华人民共和国司法部
主办：司法鉴定科学研究院
ISSN 1671-2072  CN 31-1863/N
中国司法鉴定

中国司法鉴定 ›› 2023 ›› Issue (4): 52-56.DOI: 10.3969/j.issn.1671-2072.2023.04.007

• 鉴定科学 • 上一篇    下一篇

混杂型肩袖撕裂与肩袖病变磁共振征象对比分析

刘中冲1，2，李智伟1，秦 妙1，等   

  1. 1.潍坊医学院 基础医学院，山东 潍坊261053； 2.中国人民解放军陆军第八十集团军医院 医学影像科，山东 潍坊261021
  • 收稿日期:2021-10-11 出版日期:2023-07-15 发布日期:2023-07-16
  • 通讯作者: 刘雨清（1962—），女，教授，硕士，主要从事肿瘤病理学和法医学研究。E-mail:93326684@163.com 钱学江（1964—），男，主任医师，主要从事医学影像学和介入放射学研究。E-mail:QxJ89yy@163.com
  • 作者简介:刘中冲（1988—），男，硕士，主要从事法医影像学研究。E-mail:1004991978@qq.com
  • 基金资助:
    中国人民解放军陆军第八十集团军医院基金资助项目（202104）。

Comparative Analysis of MRI Findings of Mixed Rotator Cuff Tears and Rotator Cuff Lesions

LIU Zhongchong1,2， LI Zhiwei1， QIN Miao1， et al   

  1. 1. School of Basic Medical Sciences, Weifang Medical University, Weifang 261053, China; 2. Department of Medical Imaging, Hospital of the 80th Army of the Chinese People’s Liberation Army, Weifang 261021, China
  • Received:2021-10-11 Published:2023-07-15 Online:2023-07-16

PDF

摘要： 目的 比较肩袖病变与混杂型肩袖撕裂（rotator cuff tears，RCT）磁共振成像（magnetic resonance imaging，MRI）中图像特征的差异，为肩袖撕裂伤病关系判定提供依据。方法 回顾性分析87例RCT患者的病历与MRI资料，包括16例肩袖病变与71例混杂型撕裂，其中混杂性撕裂又分为骨折脱位组（22例）和轻度创伤组（49例）。根据MRI图像测量RCT内外侧长度（medial-lateral tear size，ML）、韧带损伤数量、撕裂类型、肌骨挫伤及撕裂端脂肪浸润信号。对三组患者的基线资料和MRI测量参数进行比较。结果 ML、撕裂类型、韧带损伤数量和肌骨挫伤信号三组的比较差异具有统计学意义（P＜0.05），其中骨折脱位组ML最小、韧带损伤数量最多，轻度创伤组全层撕裂发生率最高。年龄、性别、撕裂端脂肪浸润信号这三组比较差异无统计学意义（P＞0.05）。结论  依据MRI韧带损伤数量和肌骨挫伤信号可推断创伤大小，但肩袖撕裂内外侧长度、撕裂类型与创伤大小无关。撕裂端脂肪浸润信号发生率低，判断伤病关系价值有限。

关键词: 混杂型肩袖撕裂, 法医学, 伤病关系, 磁共振成像

Abstract: Objective To compare the difference of MRI signs between rotator cuff lesions and mixed rotator cuff tears, thus to provide a basis for judging the injury-disease relationship of rotator cuff tear （RCT）. Methods Retrospective analysis of clinical and MRI data of 87 patients with RCT was carried out. In 16 cases, the patients got rotator cuff lesion, and other 71 cases got mixed type of RCT, which were further divided into fracture dislocation group （22 cases） and mild trauma group （49 cases）. The medial-lateral tear size （ML）, tear type, number of injured ligaments, musculoskeletal contusion and signal of fat infiltration at the tear end of RCT were measured. The baseline data of the three groups and their MRI measurement parameters were compared. Results There were significant differences in ML, tear type, number of injured ligaments and musculoskeletal contusion among the three groups （P<0.05）. The fracture dislocation group had the lowest ML values and the highest ligament injury numbers. The mild trauma group had the highest incidence of full-thickness tear. There was no significant difference in age, gender, and tear end fat infiltration signal among the three groups （P>0.05）. Conclusion The trauma size can be inferred from the number of ligament injuries and muscle bone contusion signals on MRI images, but the medial-lateral tear size and type of RCT are not related to the trauma size. The incidence of fat infiltration at the tear end is low, therefore its value in identifying the relationship between injury and disease is limited.

Key words: mixed rotator cuff tear, forensic medicine, relationship between injury and disease, magnetic resonance imaging（MRI）

中图分类号: