견관절자기공명관절조영술에서의 Hill-Sachs병변과 관절경에서의 Bankart병변, 견관절탈구빈도와의 상관성 Hill-Sachs Lesion on MR Arthrography of the Shoulder: Relationship with Bankart Lesion on Arthroscopy and Frequency of Shoulder Dislocations원문보기
목적: 견관절 전방탈구 후 Bankart 병변이 있었던 환자의 자기공명관절조영술 (MRA)에서 Hill-Sachs (HS) 병변의 유무와 정도를 평가하고, 이를 관절경에서 보인 Bankart 병변의 크기와 탈구 빈도와 비교하고자 하였다. 대상과 방법: 견관절 전방탈구 후 발생한 Bankart 병변의 관절경 수술을 시행 받은 86명의 MRA를 분석하였다. MRA에서 HS 병변의 가장 큰 표면길이와, 관절경에서 보인 Bankart 병변의 크기를 측정하였다. HS 병변 길이와 Bankart 병변 크기, 탈구 빈도 사이의 상관성을 분석하였다. 결과: HS 병변은 78명에서 관찰되었다. HS 병변의 가장 긴 표면길이는 평균 18.8 mm (9.3 - 29.6 mm) 였고, Bankart 병변은 평균 4.25시계구간 크기 (1-6시계구간 크기) 였다. 3명은 단일탈구, 75명은 재발탈구였다. HS 병변의 크기는 Bankart 병변의 크기와 유의한 양의 상관관계를 보였고 (p = 0.001, r = 0.37), 탈구 빈도와는 관련성이 없었다. 결론: HS 병변은 Bankart 병변이 있는 환자에서 흔하게 발견되었다. HS 병변과 Bankart 병변의 크기와 유의한 양의 상관관계를 보였다.
목적: 견관절 전방탈구 후 Bankart 병변이 있었던 환자의 자기공명관절조영술 (MRA)에서 Hill-Sachs (HS) 병변의 유무와 정도를 평가하고, 이를 관절경에서 보인 Bankart 병변의 크기와 탈구 빈도와 비교하고자 하였다. 대상과 방법: 견관절 전방탈구 후 발생한 Bankart 병변의 관절경 수술을 시행 받은 86명의 MRA를 분석하였다. MRA에서 HS 병변의 가장 큰 표면길이와, 관절경에서 보인 Bankart 병변의 크기를 측정하였다. HS 병변 길이와 Bankart 병변 크기, 탈구 빈도 사이의 상관성을 분석하였다. 결과: HS 병변은 78명에서 관찰되었다. HS 병변의 가장 긴 표면길이는 평균 18.8 mm (9.3 - 29.6 mm) 였고, Bankart 병변은 평균 4.25시계구간 크기 (1-6시계구간 크기) 였다. 3명은 단일탈구, 75명은 재발탈구였다. HS 병변의 크기는 Bankart 병변의 크기와 유의한 양의 상관관계를 보였고 (p = 0.001, r = 0.37), 탈구 빈도와는 관련성이 없었다. 결론: HS 병변은 Bankart 병변이 있는 환자에서 흔하게 발견되었다. HS 병변과 Bankart 병변의 크기와 유의한 양의 상관관계를 보였다.
Purpose : This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations. Materials...
Purpose : This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations. Materials and Methods: 86 MRA of shoulder were evaluated in patients with arthroscopic Bankart repairs following anterior dislocations. The largest surface length of HS lesion on MRA and extent of Bankart lesions on arthroscopy were measured. Relationships between length of HS lesions and extent of Bankart lesions and frequency of dislocations were assessed. Results: HS lesions were identified on MRA in 78 patients. The largest surface length of HS lesion ranged from 9.3 mm to 29.6 mm (mean, 18.8 mm). The extent of Bankart lesion ranged from one to six o'clock extent (mean, 4.25 o'clock extent). Three patients had single dislocation and the other 75 patients had recurrent dislocations (mean 24.5 times). The largest surface length of HS lesions was positively correlated with extent of Bankart lesions (p = 0.001, r = 0.37), but not with frequency of dislocation. Conclusion: HS lesion was very common in patients with Bankart lesion. The severity of HS lesions was correlated with extent of Bankart lesions.
Purpose : This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations. Materials and Methods: 86 MRA of shoulder were evaluated in patients with arthroscopic Bankart repairs following anterior dislocations. The largest surface length of HS lesion on MRA and extent of Bankart lesions on arthroscopy were measured. Relationships between length of HS lesions and extent of Bankart lesions and frequency of dislocations were assessed. Results: HS lesions were identified on MRA in 78 patients. The largest surface length of HS lesion ranged from 9.3 mm to 29.6 mm (mean, 18.8 mm). The extent of Bankart lesion ranged from one to six o'clock extent (mean, 4.25 o'clock extent). Three patients had single dislocation and the other 75 patients had recurrent dislocations (mean 24.5 times). The largest surface length of HS lesions was positively correlated with extent of Bankart lesions (p = 0.001, r = 0.37), but not with frequency of dislocation. Conclusion: HS lesion was very common in patients with Bankart lesion. The severity of HS lesions was correlated with extent of Bankart lesions.
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제안 방법
We retrospectively analyzed eighty-six MR arthrograms of the shoulder in patients who received arthroscopic Bankart repair after antecedent anterior shoulder dislocation from 2007 to 2009. All of these patients underwent direct MR arthrography of the shoulder in order to assess instability following shoulder dislocations and then received arthroscopic Bankart repair after MR imaging was performed. The patients who had bony Bankart lesion were excluded.
revealed that glenoid bone loss in patients with anterior dislocation on CT was positively correlated with the severity of Hill-Sachs deformity, although they did not evaluate the glenoid labral lesion (9). In order to determine the relationship of the severity between both lesions in our study, the measurement of the largest surface length of each Hill-Sachs lesion was compared with the extent of each Bankart lesion confirmed on arthroscopy. The extent of Hill-Sachs lesion was positively correlated with the extent of each Bankart lesion (r = 0.
Initially, two experienced musculoskeletal radiologists who were unaware of the patients’ clinical details, reviewed fifteen MR arthrograms of the shoulder which were not included in this study, as this session was to establish a baseline consensus in the findings and severity of Hill-Sachs lesion on MR images.
Surgical reports of arthroscopy were reviewed in order to determine the extent of Bankart lesion. Bankart lesion was defined as detachment of the labrum and joint capsule from the anterior glenoid rim as seen at arthroscopy.
The patients’ medical records were reviewed in order to determine the number of frequency of shoulder dislocations.
The purposes of this study were to evaluate the prevalence and the severity of Hill-Sachs lesion seen on MR arthrography in patients with Bankart lesion following anterior shoulder dislocations, and to investigate the relationship of Hill-Sachs lesions with Bankart lesions as well as with the frequency of shoulder dislocations.
대상 데이터
The patients who had bony Bankart lesion were excluded. Seventy-three males and thirteen females ranging age from 13 to 73 years (mean age, 26.4 years) were enrolled.
데이터처리
The relationship between the severity of Hill-Sachs lesion seen on MR arthrography and the extent of Bankart lesion seen at arthroscopy, was evaluated using Spearman’s rank test.
성능/효과
There are some limitations to our study. First, the presence and extent of Hill-Sachs lesions we evaluated on MR arthrography were not precisely correlated with the surgical findings, although all of our study patients had undergone the arthroscopic surgery. However, MR arthrography has been proposed as more accurate than arthroscopy for evaluating HillSachs lesions (5, 23).
This measurement could be readily applicable and reproducible in routine clinical practice, although three-dimensional quantification of a bony defect would be helpful to more accurately evaluate the extent of Hill-Sachs lesions. In this study, the largest surface length of Hill-Sachs lesion seen on MR arthrography was in range of 9.3 to 29.6 mm, with the mean being 18.8 mm.
참고문헌 (23)
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