Pathological formation of subcoracoid bursa effusion on magnetic resonance imaging studies.

IF 2.9 2区医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2024-11-25 DOI:10.1016/j.jse.2024.09.033

Daisuke Nakai, Shoji Fukuta, Jun Kawamata, Hiroshi Yonezu, Toru Maeda, Koichi Sairyo

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Abstract

Background: The subcoracoid space includes the subcoracoid bursa (SCB) and subscapular bursa (SSB). We aimed to clarify the relationship between the presence or amount of SCB effusion and other structures around the SCB on magnetic resonance imaging (MRI) and to discuss the pathological formation of SCB effusion.

Methods: Medical records and MR images of patients who had undergone MRI examinations for shoulder pain were retrospectively reviewed. The presence or absence of SCB, SSB, and subacromial-subdeltoid bursa (SASDB) effusion was evaluated. If SCB effusion was present, the largest diameter of the effusion was measured on sagittal images to represent the amount of SCB effusion. The presence or absence of communication between the SCB and SASDB or SSB effusion were also evaluated on sagittal and axial MRI.

Results: Eighty shoulders in 70 patients were analyzed. The mean age was 70.4 ± 10.4 (range, 50-87) years. Thirty-three of the 80 shoulders (41.3%) showed SCB effusion on MRI. The clinical diagnoses of these 33 shoulders were rotator cuff tear (RCT), n = 23; frozen shoulder, n = 6; subacromial impingement, n = 3; and calcific tendinopathy, n = 1. Multivariate logistic regression analysis showed that RCT (P = 0.015) and SSB effusion (P = 0.036) were significantly associated with the presence of SCB effusion, but SASDB effusion was not. In shoulders with RCT, the SCB communicated with the SASDB in 65.2%, and with the SSB in 4.3%. In other shoulders, the SCB communicated with the SASDB in 60.0%, and with the SSB in 40.0%. The rate of SCB-SSB communication was significantly higher in shoulders without RCT than in shoulders with RCT (P = 0.021). The largest diameter of SCB effusion was normally distributed in 33 shoulders (4.7-34.8 mm), and mean 19.6 ± 7.4 mm. The largest diameter of SCB effusion was 21.9 ± 6.3 mm in 23 shoulders with RCT, and 13.5 ± 6.8 mm in 10 other shoulders (P < 0.05). Multiple regression analysis showed that RCT (P = 0.002) and SSB effusion (P = 0.029) were significantly associated with the largest diameter of SCB effusion, but SASDB effusion was not.

Conclusion: SCB effusion can be recognized and extended by inflow from SASDB effusion in RCT. Without RCT, SCB effusion may occasionally be visible due to inflow from SSB effusion.

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磁共振成像研究中的冠状滑囊下积液病理形成。

背景：肩胛下间隙包括肩胛下滑囊（SCB）和肩胛下滑囊（SSB）。我们的目的是明确磁共振成像（MRI）上弧下滑囊积液的存在或数量与弧下滑囊周围其他结构之间的关系，并探讨弧下滑囊积液的病理形成：方法：回顾性分析因肩部疼痛接受磁共振成像检查的患者的病历和磁共振图像。方法：回顾性分析因肩部疼痛接受磁共振成像检查的患者的病历和磁共振图像，评估是否存在SCB、SSB和肩峰下滑囊（SASDB）积液。如果存在肩峰滑囊积液，则在矢状面图像上测量积液的最大直径，以表示肩峰滑囊积液的量。矢状面和轴向核磁共振成像还评估了 SCB 与 SASDB 或 SSB 渗出物之间是否存在沟通：对 70 名患者的 80 个肩部进行了分析。平均年龄为 70.4 ± 10.4（50-87）岁。80 个肩部中有 33 个（41.3%）在磁共振成像中显示有 SCB 渗出。这 33 个肩部的临床诊断为肩袖撕裂（RCT），23 个；肩周炎，6 个；肩峰下撞击，3 个；钙化性肌腱病，1 个。多变量逻辑回归分析显示，RCT（P = 0.015）和SSB渗出（P = 0.036）与SCB渗出显著相关，但SASDB渗出与之无关。在有 RCT 的肩部中，65.2% 的 SCB 与 SASDB 相通，4.3% 的 SCB 与 SSB 相通。在其他肩部，60.0% 的 SCB 与 SASDB 沟通，40.0% 的 SCB 与 SSB 沟通。无 RCT 肩部的 SCB 与 SSB 沟通率明显高于有 RCT 的肩部（P = 0.021）。在 33 个肩部中，SCB 流出液的最大直径呈正态分布（4.7-34.8 毫米），平均值为 19.6 ± 7.4 毫米。在 23 个有 RCT 的肩部中，SCB 渗出物的最大直径为 21.9 ± 6.3 毫米，在其他 10 个肩部中，最大直径为 13.5 ± 6.8 毫米（P < 0.05）。多元回归分析显示，RCT（P = 0.002）和SSB渗出（P = 0.029）与SCB渗出的最大直径显著相关，但SASDB渗出与之无关：结论：在RCT中，SCB渗出可通过SASDB渗出的流入识别并扩展。结论：在 RCT 中，SCB 流出物可通过 SASDB 流出物的流入而被识别和扩展；在没有 RCT 的情况下，由于 SSB 流出物的流入，SCB 流出物可能偶尔可见。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.