雙重對比肩關節電腦斷層攝影－肩關節盂軟骨唇病變之診斷

Double Contrast CT Arthrography of the Shoulder-Assessment of the Glenoid Labrum

張政彥(Cheng-Yen Chang) ； 吳濬哲(Jiunn-Jer Wu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 11卷3期 (1986/09) Pp. 175-183

摘要

當關節盂軟骨唇(glenoid labrum)裂傷或關節囊(capsule)變大變鬆時則可能破壞了肩關節的穩定性，常造成肩關節復發性脫位。因此孟軟骨唇及關節囊病變之偵測，對外科手術前之評估與計劃是很有幫助的。從民國74年7月至75年8月共有22疑盂軟骨唇裂傷之病患接受雙重對比肩關節攝影及雙重對比肩關節電腦斷層攝影。我們發現孟軟骨唇之病變如變鈍、變薄、消失、斷裂、異位等異常皆可由雙重對比肩關節電腦斷層攝影準確的偵測出來。另外對於關節囊之異常、骨盂斷裂以及肱骨頭之壓迫性骨折的偵測亦非常的敏感、可靠。22位病患中，取重對比電腦斷層攝影偵測出15位有盂軟骨唇異常，然而刃重對比肩關節攝影只能偵測出5位病患有盂軟骨唇異常，因此對於盂軟骨唇之偵測，雙重對比肩關節電腦斷層攝影是遠優於雙重對比肩關節攝影。由於國內尚未有相關之論著，所以本文的目的在於介紹這種檢查之應用同時將此檢查之結果與雙重對比肩關節攝影結果作比較並加以討論。

並列摘要

Shoulders are prone to recurrent dislocation (almost always anterior) generally have an injured labrum and/or a lax or ballooned capsule. Imaging of glenoid labrum pathology is very useful to help plan surgical reconstruction of the dislocating shoulder. Twenty-two patients suspected labrum damage were imaged with computed tomography (CT) immediately after routine double contrast shoulder arthrography. Leisons indentified included blunting, attenuation, tears and displacement of labrum as well, as stripping, stretching of anterior shoulder joint capsule, Bankart lesion and Hill-Sachs defects. In our series, 15 cases of abnormal labrum could be demonstrated by double-contrast CT arthrography and only 5 cases of abnormal labrum could be detected by double contrast arthrography. It indicated that CT arthrography was more sensitive than double-contrast arthrography in assessing the glenoid labrum. Since double contrast CT arthrography is easy to perform, low in radiation dose and very accurate in assessing the glenoid labrum. We believe that double-contrast CT arthrography is the diagnostic method of choice for the unstable shoulders.