透析肩に対する MR イメージングの検討

抄録

The purpose of this study was to evaluate shoulder magnetic resonance (MR) imaging in patients who have hemodialysis (HD)-related shoulder pain. Eight patients (5 men and 3 women, who suffered from HD-related shoulder pain underwent 1.5-T MR imaging to confirm their shoulder structure with conventional (T1WI, T2WI) and fat suppression techniques. The mean duration of HD was 23.1 years (range, 5-29 years). The measurements of thickness of rotator cuff were obtained 1 cm away from the site of insertion at humeral head, and vertically in the course of the tendons. If the measurement was greater than 6 mm of thickness, it was considered to be abnormal in accordance with previous reports. The group of patients who suffered from periarthritis of the shoulder was used as the control group. Not only subscapularis (n=5) and supraspinatus tendon (n=6), but also infraspinatus (n=5) tendon was considered to obtain thickness. The average thickness of each rotator cuff were as below; Subscapularis tendon was 7.87 mm (SD 1.84 mm), supraspinatus tendon was 8.08 mm (SD 2.58 mm), infraspinatus tendon was 7.19 mm (SD 1.46 mm), and teres minor tendon was 4.73 mm (SD 1.85 mm). Compared to the control group, the thickness was significantly increased in subscapularis tendon, supraspinatus tendon and infraspinatus tendon. Diameter of long head of biceps tendon was also greater in HD group than the control with significant difference (p=0.004). All cases of 8 subjects had a total of 18 intraosseous lesions at MR imaging. Effusion in subacromial space was observed in 7 (87.5%) of 8. Infraspinatus and teres minor tendon as well as subscapularis and supraspinatus tendon would become thickened in patients with HD-related shoulder pain. Bone cyst in humeral head was observed in all our cases. Assessment of MR imaging for this disease would be useful for further treatment.