CAJ | 학술논문

目的：探讨肩峰分型及其与肩峰下撞击综合症的相关性。方法选择经临床证实的97例肩峰下撞击综合症患者，按年龄段分成A组（39岁以下）、B组（40～59岁）和C组（60岁以上）三组，共97个肩关节进行MSCT扫描，将原始数据1mm薄层重建后在工作站上行容积再现（VR）、多平面重组（MPR）、最大密度投影（MIP）等后处理，观察肩峰解剖形态并分型、测肩峰-肱骨头间距（A-H间距）。结果 I型扁平型23肩，占23．7％，II型弯曲型30肩，占30．9％，III型钩型44肩，占45．4％；I、II型肩峰所占比例随年龄增加而减少，III型肩峰随年龄增加而增多，A、B组及A、C组II、III肩峰比例差异有统计学意义；Ⅰ型和Ⅱ型肩峰在左、右肩分布无明显差异，Ⅲ型肩峰以右肩居多，左右肩III型肩峰比例差异有统计学意义；I、III型及II、III型肩峰A-H间距＜5mm组比例差异有统计学意义，III型所占比例最高。结论 MSCT 可以清晰显示肩关节的解剖及其形态，钩型肩峰以右肩多见，且随年龄增加而增加，肩峰下撞击综合症的发生率明显高于其他两型。
목적：탐토견봉분형급기여견봉하당격종합증적상관성。방법선택경림상증실적97례견봉하당격종합증환자，안년령단분성A조（39세이하）、B조（40～59세）화C조（60세이상）삼조，공97개견관절진행MSCT소묘，장원시수거1mm박층중건후재공작참상행용적재현（VR）、다평면중조（MPR）、최대밀도투영（MIP）등후처리，관찰견봉해부형태병분형、측견봉-굉골두간거（A-H간거）。결과 I형편평형23견，점23．7％，II형만곡형30견，점30．9％，III형구형44견，점45．4％；I、II형견봉소점비례수년령증가이감소，III형견봉수년령증가이증다，A、B조급A、C조II、III견봉비례차이유통계학의의；Ⅰ형화Ⅱ형견봉재좌、우견분포무명현차이，Ⅲ형견봉이우견거다，좌우견III형견봉비례차이유통계학의의；I、III형급II、III형견봉A-H간거＜5mm조비례차이유통계학의의，III형소점비례최고。결론 MSCT 가이청석현시견관절적해부급기형태，구형견봉이우견다견，차수년령증가이증가，견봉하당격종합증적발생솔명현고우기타량형。
Objective To discuss the correlationship of acromion classification and morbidity of the subacromial impinge-ment syndrome .Methods 97 patients diagnosed as subacromial impingement syndrome were divided into three groups ac-cording to the age ,Group A(≤39 yrs) ,Group B (40~59 yrs) and Group C (≥60 yrs) .All glenohumeral joints of the 97 cases underwent multi slice spiral computed tomography (MSCT ) scanning and three dimensional reconstructed at 1 mm thin slices .Then volume rendering (VR) ,multi-planar reconstruction (MPR) and maximum intensity projection (MIP) were taken to observe the anatomy and the classification of the joints ,additionally ,the distance of the acromial-humeral gap (A-H gap) was measured .Results 23 .7 percent of the cases (23/97) were type Ⅰ (flat shoulder) ,30 .9 percent (30/97) were type Ⅱ (arc-shaped shoulder) ,45 .4 percent (44/97) were type Ⅲ (hook-shaped shoulder) .The proportion of type Ⅰ and Ⅱ decreased with increasing age ,but type Ⅲ increased .The proportion of type Ⅱ was significantly differ-ent between Group A and B ,Group A and C ,so did type Ⅲ .There was no significant difference proportion of typeⅠ andⅡ between the left and right shoulder .Type Ⅲ were seen more frequently in the right shoulder ,which was significantly less in the left side .The proportion of A-H interval <5mm part was statistically different between typeⅠ and Ⅱ ,type Ⅰand Ⅲ ,furthermore ,which was the highest in type Ⅲ .Conclusion MSCT can clearly show the anatomy and morphology of the shoulder joint .The hook-shaped shoulder is more frequent in the right side ,and increases with increasing age ,the morbidity of subacromial impingement syndrome are significantly higher than that of the other two groups .