MR (Magnetresonanz)-Arthrographie der Schulter: Anatomie des normalen Schultergelenkes und der Rotatorenmanschette im MRT

MR (Magnetresonanz)-Arthrographie der Schulter: Anatomie des normalen Schultergelenkes und der Rotatorenmanschette im MRT

MR (Magnetresonanz)-Arthrographie der Schulter: Anatomie des normalen Schultergelenkes und der Rotatorenmanschette im MRT

Dieses Modul e-Anatomy widmet sich der Anatomie des Schultergelenks und der Rotatorenmanschette auf einer MR-Arthographie.

Diese MR-Arthrografie der Schulter wurde von Dr. Corey Chakarun, Shin Imaging, Kalifornien, USA, an einem männlichen Patienten mit dem MRT-Gerät Signa Pioneer 3T von GE durchgeführt. Der Untersuchungsbefund ist aufgrund einer chronischen Verletzung des anteroinferioren Labrum-Ligament-Komplexes nicht normal.

Eine Injektion von 12 ml einer Gadoliniumlösung (Verdünnung 1:200) wurde unter Durchleuchtungskontrolle mit einem anterioren Zugang (Patient in Rückenlage mit der Schulter in leichter Aussenrotation) in das Schultergelenk gespritzt.

Dann wurde die MRT mit der Schulter in neutraler Rotation durchgeführt (mit Ausnahme der ABER-Sequenz), mit 5 verschiedenen Sequenzen, die üblicherweise für die MR-Arthographie des Schultergelenks verwendet werden:

  • Axial T1-weighted fat saturation
MR Arthrography of the shoulder in Axial T1 FS: Normal anatomy of the glenohumeral joint and of the rotator cuff. This MRI shows the labrum, the tendons of the rotator cuff muscles, the glenohumeral ligaments, the articular capsule and the subacromial-subdeltoid bursa
Axial T1 FS image shows the normal anatomy of the glenohumeral joint and the rotator cuff on a MR (Magnetic Resonance) arthrography of the shoulder. On this MRI the labrum, the tendons of the rotator cuff muscles, the glenohumeral ligaments, the articular capsule and the subacromial-subdeltoid bursa can be distinguished.

 

  • Oblique coronal T1-weighted fat saturation
Shoulder MR arthrogram on coronal F1 FS showing the anatomy of the normal glenohumeral joint and of the rotator cuff
This oblique coronal T1-weighted fat saturation image shows the anatomy of the normal glenohumeral joint and of the rotator cuff

 

  • Oblique coronal PD-weighted fat saturation
Shoulder MR Arthogram in coronal PD FS showing the rotator cuff, the musculotendinous cuff, the supraspinatus tendon, the infraspinatus muscle, the subacromial bursa and the subdeltoid bursa
This oblique coronal PD-weighted fat saturation image shows the rotator cuff, the musculotendinous cuff, the supraspinatus tendon, the infraspinatus muscle, the subacromial bursa and the subdeltoid bursa

 

  • Oblique sagittal T1-weighted FSE
Shoulder MR arthrogram on sagittal T1 showing the articular surface of glenoid, the glenoid labrum, the bicipital-labrum complex and the glenohumeral ligaments
This oblique sagittal T1-weighted FSE image shows the articular surface of glenoid, the glenoid labrum, the bicipital-labrum complex and the lenohumeral ligaments

 

  • T1-weighted fat saturation in abduction and external rotation (ABER)
Shoulder MR arthrogram in the ABER position-T1 FS: the glenohumeral joint, the shoulder joint, the supraspinatus tendon, the glenoid labrum can be distinguished
This T1-weighted fat saturation was performed in abduction and external rotation (the ABER position). It shows the glenohumeral joint, the shoulder joint, the supraspinatus tendon and the glenoid labrum

 

Die anatomischen Strukturen wurden auf den MR-Bildern von Dr. Antoine Micheau und Dr. Denis Hoa nach der neuen Terminologia Anatomica (TA2 - 2020) beschriftet und um einige im Alltag gebräuchliche Begriffe für die radiologische Anatomie des Schultergelenks ergänzt.

 

 

MR Arthrography of the shoulder in Axial T1 FS: Normal anatomy of the glenohumeral joint and of the rotator cuff. This MRI shows the labrum, the tendons of the rotator cuff muscles, the glenohumeral ligaments, the articular capsule and the subacromial-subdeltoid bursa
Abbildung 1 - Axial T1 FS image shows the normal anatomy of the glenohumeral joint and the rotator cuff on a MR (Magnetic Resonance) arthrography of the shoulder. On this MRI the labrum, the tendons of the rotator cuff muscles, the glenohumeral ligaments, the articular capsule and the subacromial-subdeltoid bursa can be distinguished.
Shoulder MR arthrogram on coronal F1 FS showing the anatomy of the normal glenohumeral joint and of the rotator cuff
Abbildung 2 - This oblique coronal T1-weighted fat saturation image shows the anatomy of the normal glenohumeral joint and of the rotator cuff
Shoulder MR Arthogram in coronal PD FS showing the rotator cuff, the musculotendinous cuff, the supraspinatus tendon, the infraspinatus muscle, the subacromial bursa and the subdeltoid bursa
Abbildung 3 - This oblique coronal PD-weighted fat saturation image shows the rotator cuff, the musculotendinous cuff, the supraspinatus tendon, the infraspinatus muscle, the subacromial bursa and the subdeltoid bursa
Shoulder MR arthrogram on sagittal T1 showing the articular surface of glenoid, the glenoid labrum, the bicipital-labrum complex and the glenohumeral ligaments
Abbildung 4 - This oblique sagittal T1-weighted FSE image shows the articular surface of glenoid, the glenoid labrum, the bicipital-labrum complex and the lenohumeral ligaments
Shoulder MR arthrogram in the ABER position-T1 FS: the glenohumeral joint, the shoulder joint, the supraspinatus tendon, the glenoid labrum can be distinguished
Abbildung 5 - This T1-weighted fat saturation was performed in abduction and external rotation (the ABER position). It shows the glenohumeral joint, the shoulder joint, the supraspinatus tendon and the glenoid labrum
  • Normal Shoulder MRI and MR Arthrography: Anatomy and Technique. Seminars in musculoskeletal radiology.Llopis, Eva & Montesinos, Pau & Guedez, M & Aguilella, Luis & Cerezal, Luis. (2015). 19. 212-30. 10.1055/s-0035-1549316
  • The anterior glenohumeral joint capsule: macroscopic and MRI anatomy of the fasciculus obliquus or so-called ligamentum glenohumerale spirale - Griffin N, Charles-Edwards G, Grant LA. Magnetic resonance cholangiopancreatography: the ABC of MRCP. Insights Imaging. 2012;3(1):11–21. doi:10.1007/s13244-011-0129-9
  • Transverse Thickening Along the Articular Surface of the Rotator Cuff Consistent With the Rotator Cable: Identification With MR Arthrography and Relevance in Rotator Cuff Evaluation. Kenneth Sheah, Miriam A. Bredella, Jon J. P. Warner, Elkan F. Halpern, and William E. Palmer American Journal of Roentgenology 2009 193:3, 679-686
  • Terminologia anatomica: international anatomical terminology By the Federative Committee on Anatomical Terminology (FCAT).  Stuttgart:  Georg Thieme Verlag.  ISBN-10: 3-13-114361-4. ISBN-13: 978-3-13-114361
anatomische Strukturen