肩关节磁共振诊断介绍.ppt

肩关节磁共振诊断 肩关节磁共振诊断 骨性出口与肩峰 肩袖 关节囊和盂唇 骨性结构和关节面 肱二头肌 其他 骨性出口和肩峰 骨性弓状结构包围肩袖肌腱 机械性碰撞导致肩袖肌腱退变 前肩峰是导致肩袖碰撞最重要的结构 Anterior Acromion Most Important Structure Leading to Impingement 肩 峰 形态分型（I，II，III） 前/外侧下倾型肩峰 下缘骨赘形成 骨性出口和肩峰 肩峰 形态分类，下倾型肩峰，骨赘，肩峰发育异常 肩锁关节 退变，关节囊肥厚(是否存在团块样表现？) 喙肩韧带(是否增厚?) 喙肱间距 (肩胛下区是否有碰撞?) 肩袖病变 Tendonopathy肌腱病变 Tear撕裂 Partial Thickness, Full Thickness, Complete 部分撕裂，全层撕裂，完全撕裂 Musculotendinous Retraction肌肉肌腱回缩 Fatty Atrophy脂肪肥厚 HADD/ Calcific Tendonitis钙化性肌腱炎 肩袖病变Rotator Cuff Pathology Tendonopathy 肌腱病变 Tear 撕裂 Partial Thickness, Full Thickness, Complete 部分撕裂，全层撕裂，完全撕裂 Musculotendinous Retraction 肌肉肌腱回缩 Fatty Atrophy 脂肪增厚 Calcific Tendonitis 钙化性肌腱炎 关节囊结构和盂唇Capsular Structures and Labrum Patient under 35 y. o. with GH Instability or Unexplained Shoulder Pain 35岁以下患者出现肩关节不稳定或无法解释的肩部疼痛 MR Arthrography 适合进行MR关节造影 Labral Lesions Common 盂唇病变较为常见 Subtle Lesions (nondisplaced, resynovialized) -Distention Effects of Contrast 小病变（未移位，滑膜化）-对比剂的遮蔽效应 肩关节表面和骨性结构Osseous Structures and Articular Surfaces Hematopoietic Bone Marrow 局部红骨髓变 Subcortical Cystic Change皮质下囊变 Trauma (Fracture)创伤（骨折） Arthritis 关节炎 Infection 感染 Tumor 肿瘤 肱二头肌病变Biceps Tendon Tendonitis 肌腱炎 Tear 肌腱撕裂 Dislocation 脱位 Intra-articular 关节内脱位 Extra-articular 关节外脱位 Systematic Approach to the Shoulder肩关节读片要领 Osseous Outlet and Acromion Acromial Type, Anterior/Lateral Down Sloping, Spur, Os Acromiale; AC Joint; C-A Ligament 骨性出口和肩峰 肩峰类型，前/后下斜型，骨赘，肩峰小骨，肩锁关节，喙肩韧带 Rotator Cuff Tendonopathy, Partial Thickness, Full Thickness, Complete Tear; Fatty Atrophy, Retraction 肩袖 -肌腱病变，部分撕裂，全层撕裂，完全撕裂，脂肪性萎缩，韧带回缩 Systematic Approach to the Shoulder肩关节读片要领 Capsule and Labrum Labral Tear; Anterior; SLAP; Posterior 关节囊和盂唇 盂唇撕裂；前盂唇病变；SLAP；后盂唇病变 Osseous Structures and Articular Surfaces Trauma; Arthritis; Infection; Tumor 骨性结构和关节面 创伤；关节炎；感染；肿瘤 Biceps Tendon Tendonopathy; Tear; Dislocation 肱二头肌腱 肌腱病变；撕裂；脱位 肱二头肌腱脱位 Biceps Tendon Dislocation -Extra-articular: Transverse Ligament Torn; Subscapularis Intact 关节外脱位：横韧带撕裂；肩胛下肌完