基于MRI评估男性盂肱关节解剖结构与Bankart损伤的相关性OA
MRI-based assessment of the correlation between glenohumeral joint anatomy and Ban-kart lesion in males
目的 探讨基于 MRI 评估男性盂肱关节解剖结构与 Bankart 损伤的相关性.方法 选择 2021-05 至 2025-05武警浙江总队医院收治的临床诊断为 Bankart 损伤的患者 120 例为研究组.并通过医学影像管理系统(PACS)和电子病历系统,选取同时段因肩关节不适就诊的 120 例患者为对照组,对照组排除既往肩关节脱位、手术及外伤史.两组患者均行 MRI检查,观察分析肩关节 Bankart 的影像学特征,测量、计算并对比两组病例肩关节关节盂宽度、高度、肱骨头宽度、关节盂高宽比及盂肱错配率,采用 Logistic 回归分析评估肩关节 Bankart 损伤的高危因素.采用受试者工作特征(ROC)曲线评价相关指标预测 Bankart 的效能.结果 Bankart 损伤 MRI 图像上表现为盂唇形态不规则、变钝或缺失,T2 WI 显示盂唇内高信号,盂唇与肩盂关节面分离,伴有肱骨头 Hill-Sachs 骨折;研究组和对照组之间的关节盂高度、肱骨头宽度差异无统计学意义,研究组的关节盂宽度、关节盂表面积小于对照组,关节盂高宽比、盂肱错配率大于对照组,差异有统计学意义(P<0.05).年龄、BMI指数、关节盂高度、肱骨头宽度均不是肩关节 Bankart 损伤的危险因素;关节盂宽度、关节盂高宽比、盂肱错配率是肩关节 ban-kart 损伤发生的危险因素(P<0.05).关节盂高宽比(OR=243.69,95%CI:13.17~4508.72)是肩关节 Bankart 损伤发生的独立危险因素.关节盂高宽比预测肩关节 Bankart 损伤的曲线下面积(AUC)为 0.72,最佳临界值为 1.60,敏感度为 71.67%,特异度为 54.17%.结论 MRI 能准确显示肩关节盂唇损伤,是诊断 Bankart 损伤的可靠方法.较大的关节盂高宽比是男性肩关节前向不稳定的重要风险因素.
Objective To analyze the MRI-based assessment of the correlation between glenohumeral joint anatomy and Bankart lesion in males.Methods A total of 120 patients diagnosed with Bankart lesion at Zhejiang Provincial Corps Hospital of Chinese People's Armed Police Force from May 2021 to May 2025 were selected as the study group.Through the medical imaging management system(PACS)and electronic medical record system,another 120 patients who visited the hospital due to shoulder joint discomfort dur-ing the same period were selected as the control group,excluding those with previous shoulder joint dislocation,surgery,or trauma histo-ry.Both groups underwent MRI examination.The MRI imaging features of Bankart lesions were observed and analyzed.The width and height of glenoid,the width and height of humeral head,the ratio of the width and height of glenoid,and the rate of glenohumeral dislo-cation were measured and compared between the two groups.Logistic regression analysis was used to evaluate the high-risk factors of Ban-kart lesion of the shoulder joint,and the receiver operating characteristic(ROC)curve was used to assess the predictive value of related indicators.Results Bankart lesions showed irregular,blunt or missing labrum morphology on MRI images,T2WI showed high signal in-tensity in labrum and glenoid articular surface separation,accompanied by Hill-Sachs fracture of the humeral head.There was no statisti-cally significant difference in the height and width of the glenoid fossa and humeral head width between the two groups(P>0.05),The width and surface area of the glenoid of the study group were smaller than those of the control group,while the ratio of the height to width of the glenoid and the rate of glenohumeral mismatch were greater than those of the control group,with statistically significant differences(P<0.05).Age,BMI index,glenoid height and humeral head width were not risk factors for Bankart lesion of the shoulder joint,while the glenoid width,the ratio of glenoid height to width and the rate of gleno-humeral dislocation were risk factors(P<0.05).Glenoid height-to-width ratio(OR=243.69,95%CI:13.17~4508.72)was an independent risk factor for Bankart lesion.The area under the curve(AUC)of glenoid height-to-width ratio predicting Bankart lesion was 0.72,with an optimal cut-off value of 1.60,sensitivity of 71.67%,and specificity of 54.17%.Conclusions MRI can accurately display glenoid labrum lesion of shoulder joint and is a reliable method to diag-nose the lesion.A larger glenoid height-to-width ratio is an important risk factor for anterior instability of shoulder joint in males.
陈帅;高超;余艳凤;徐超;谢胜宇;张联合
310051 杭州,武警浙江总队医院医学影像科310051 杭州,武警浙江总队医院医学影像科310051 杭州,武警浙江总队医院医学影像科310051 杭州,武警浙江总队医院医学影像科310051 杭州,武警浙江总队医院医学影像科310051 杭州,武警浙江总队医院医学影像科
医药卫生
Bankart损伤肩关节前向不稳肩关节脱位磁共振成像关节盂高宽比
Bankart lesionanterior instability of shoulder jointshoulder dislocationmagnetic resonance imaging(MRI)glenoid height-to-width ratio
《武警医学》 2026 (4)
296-300,305,6
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