Diagnostic Value Of Different Acromial Inclination Indicators Measured By MSCT And MRI In Shoulder Impingement Syndrome

Part 1 Diagnostic Value of Acromial Inclination Angles Measured by MSCT in Shoulder Impingement SyndromeObjective:To explore the diagnostic value of different acromion inclination angles measured by multi-slice spiral computed tomography three-dimensional reconstruction technique in shoulder impingement syndrome.Methods:The clinical and imaging data of 78 cases(case group)diagnosed as SIS and 38 cases(control group)of simple joint glenoid labrum,rotator cuff injury or normal shoulder joint in the period from June 2015 to July 2017 were retrospectively analyzed.All patients were examined by MSCT and MR.The acromial inclination angle α,βandγ were measured on MSCT three-dimensional reconstruction images and the data obtained were statistically analyzed.The MR examination was used to identify the injury of the rotator cuff.Results:The t values of the independent sample t test of the acromion inclination angle α,βandγin the case group and the control group were-8.09,10.84,and-7.10 respectively,(P < 0.05);The correlation coefficient r of the acromion inclination angle α,βandγ with AHI were 0.86,-0.92 and 0.84,respectively,(P < 0.05);The constituent ratio of acromion of type III between case group and the control group was 6.84,(P < 0.05);The area under the Curve(AUC)of acromial inclination angle α,βandγ between the case group and the control group were 0.87,0.94 and 0.84,respectively.Compared with Z test,the results of the three groups α-β,α-γ,β-γ were 2.06(P < 0.05),0.71(P > 0.05),2.44(P < 0.05),respectively.The most diagnostic value was the acromion inclination angle β(sensitivity 84.6%,specificity92.1%).Conclusion:All of the acromion inclination angles have a certain diagnostic value for SIS,and the acromion inclination angle β has the highest diagnostic value;Type III acromion can promote the formation of SIS.Part 2 Diagnostic Value of the Inclination of Acromion Measured by MRI in Shoulder Impingement SyndromeObjective:To explore the diagnostic value of different acromion inclination indicators measured by MRI in shoulder impingement syndrome.Methods:A retrospective analysis of 141 patients with shoulder pain from January 2017 to June 2017 was conducted.Among them,96 patients(case group)who were diagnosed with SIS by clinical and imaging examination,and 45 patients with non-SIS(control group).All cases were examined by MR and the indicators of MRI images were measured,including acromio humeral intervals,acromion angle,angle of acromioclavicular joint,angulation of acromioclavicular joint and the degree of injury of supraspinatus tendon,the data obtained were statistically analyzed.Results:96 cases(100%)of the supraspinatus tendon in case group were injured,and 38 cases(84.4%)of the supraspinatus tendon were injured in the control group;There was a statistically significant difference in acromion angle,angulation of acromioclavicular joint,AHI,and the degree of injury of supraspinatus tendon between the case group and the control group(P<0.05),which was valuable for the diagnosis of SIS;There was no significant difference in the angle of acromioclavicular joint between the case group and the control group(P>0.05);Acromion angle is related to the angulation of acromioclavicular joint and AHI(The both value of r were-0.428,P<0.05),the angulation of acromioclavicular joint is related to the AHI(The value of r was 0.512,P<0.05);There was no correlation between the degree of injury of supraspinatus tendon and various indicators(P>0.05).The AUC values of acromion angle,angulation of acromioclavicular joint and AHI between case group and control group were 0.823,0.697 and 0.752 respectively.Compared with Z test,the results of the three groups of acromion angle-the angulation of acromioclavicular joint,acromion angle-AHI and the angulation of acromioclavicular joint-AHI were 2.09(P<0.05),1.19(P>0.05)and 0.85(P>0.05),respectively.Conclusion:The inclination of acromion is an important factor affecting SIS and has diagnostic significance for SIS;The acromion angle and angulation of acromioclavicular joint can be used as the diagnostic basis of SIS.