Abstract: Objective The distribution and length of the tear area and the degree of the contracture of the broken end of the rotator cuff tear image were measured and compared with the tear morphology seen during the operation. Methods From October 2019 to December 2021, a total of 38 patients who met the research criteria and underwent arthroscopic or open repair due to rotator cuff tear were collected. The distribution area, length, and degree of contracture of rotator cuff tear were measured by this method, and the general shape of the tear was described before surgery and compared with the intraoperative situation. The main comparison parameters included distribution area and length of preoperative MRI oblique sagittal and intraoperative tears, and degree of oblique coronal contracture. Paired sample rank sum test was used for statistical analysis. The preoperative MRI measurements and intraoperative measurements were compared for statistical differences. At the same time, the common area of tears was calculated, and the consistency of preoperative and intraoperative tear morphology was compared. Results A total of 38 patients (20 males and 18 females), ranging in age from 37 to 73 years, were enrolled. There was no significant difference in rotator cuff tear length and contracture degree measured by oblique coronal MRI before operation (P=0.427; P=1.000). There was no significant difference in the length of rotator cuff tear and the degree of contracture between the preoperative MRI and the actual incision measurement (P=0.341; P=1.000). There was no significant difference between preoperative MRI and actual intraoperative microscopic measurement (P=0.865; P =1.000). Statistical analysis of rotator cuff tear zones showed that there was no significant statistical difference between the origin and end areas of the tear shown by preoperative MRI and the actual intraoperative tear origin and end areas (P=0.180; P=0.411), and the distribution frequency of tear zone was high in zones 1~5. Conclusion Preoperative MRI measurement and description of tear partition can show the tear morphology relatively intuitively, and has good consistency with the tear morphology seen under microscope and incision. It is helpful to plan the distribution of anchor and suture method during operation. Shorten the learning curve of shoulder arthroscopy. To improve the consistency of interpretation of tear morphology between surgeons and radiologists.

Key words: rotator cuff tear, shoulder MRI, arthroscope, glenohumeral kinematics

摘要： 目的 建立术前MRI分区,测量肩袖撕裂影像的撕裂区分布及长度、断端挛缩程度,并与术中所见撕裂形态进行比较。方法 收集2019年10月~2021年12月,因肩袖撕裂行关节镜下或切开修复,并符合研究标准的患者共38例,通过本方法测量肩袖撕裂的分布区、长度,挛缩程度,在术前描述撕裂的大致形态,与术中情况进行对比。其主要对比的参数包括：术前MRI斜矢状位与术中撕裂的分布区及长度,斜冠状位挛缩程度。统计方法采用配对样本秩和检验。比较术前MRI测量与术中测量的是否存在差异。同时计算撕裂的多发区,并比较术前及术中撕裂形态相符性。结果 共纳入38例患者(男性20例,女性18例),年龄范围37~73岁。术前斜冠状位MRI所测得肩袖撕裂长度、挛缩程度与术中实际测量结果比较无显著统计学差异（P=0.427;P=1.000）。切开修复患者的术前MRI肩袖撕裂长度、挛缩程度与术中实际切开测量结果比较也未发现显著统计学差异（P=0.341;P=1.000）。镜下修复患者术前MRI与术中实际镜下测量结果比较同样无统计学差异（P=0.865;P=1.000）。统计肩袖撕裂分区发现,术前MRI所示的撕裂起点区、终点区与术中实际所见的撕裂起点区、终点区比较未发现明显统计学差异（P=0.180;P=0.411）,且撕裂区分布频率高发于1~5区。结论 术前MRI测量及撕裂分区的描述可以相对直观的显示撕裂的形态,并与镜下及切开所见的撕裂形态具有良好一致性。有利于规划术中锚钉分布与缝合方式。缩短肩关节镜学习曲线。提高术者与影像医师对撕裂形态判读的一致性。

关键词: 肩袖损伤, 肩关节MRI, 关节镜, 盂-肱关节运动