臨床整形外科54巻9号

2019年09月発行

誌上シンポジウム 肩腱板断裂 画像診断の進歩

MRIによる腱板の筋萎縮・脂肪変性評価

IDEAL法による腱板筋の脂肪変性の評価

著者： 落合信靖¹

所属機関： ¹千葉大学大学院医学研究院整形外科

ページ範囲：P.889 - P.896

文献概要

　IDEAL法は，3つのエコー時間を設定しデータを収集する3-point Dixon法で，水と脂肪を非常に高い精度で分離できる脂肪定量可能な新たなMRI撮像法である．当院におけるIDEAL法を用いた検討で，術前の棘上筋の筋実質部と棘下筋の術前の脂肪変性が腱板修復術後の再断裂のリスクファクターであり，術前の筋脂肪変性が進行した症例では腱板修復術において注意を要すると考えられる．

参考文献

1) Gladstone JN, Bishop JY, Lo IK, et al. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 2007;35(5):719-28.

2) Goutallier D, Postel JM, Bernageau J, et al. Fatty muscle degeneration in cuff ruptures. Pre- and post operative evaluation by CT scan. Cin Orthop Relat Res 1994;304:78-83.

3) 松木圭介，菅谷啓之，落合信靖・他．T2マッピングによる腱板筋の脂肪浸潤の定量的評価．肩関節2009；33(3)：693-6．

4) Alizai H, Nardo L, Karampinos DC, et al. Comparison of clinical semi-quantitative assessment of muscle fat infiltration with quantitative assessment using chemical shift-based water/fat separation in MR studies of the calf of post-menopausal women. Eur Radiol 2012;22(7):1592-600.

5) Gloor M, Fasler S, Fischmann A, et al. Quantification of fat infiltration in oculopharyngeal muscular dystrophy:comparison of three MR imaging methods. J Magne Reson Imaging 2011;33(1):203-10.

6) Warner JJ, Higgins L, Parsons IM 4th, et al. Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elbow Surg 2001;10:37-46.

7) 渡辺淳也，和田佑一，小畠隆行・他．MEDAL法を用いた骨格筋内脂肪含有率，水分含有率の評価．日整会誌2009；83(8)：1140．

8) Kenn W, Böhm D, Gohlke F, et al. 2D SPLASH:a new method to determine the fatty infiltration of the rotator cuff muscles. Eur Radiol 2004;14(12):2331-6.

9) Meisamy S, Hines CD, Hamilton G, et al. Quantification of hepatic steatosis with T1-independent, T2*-corrected MR imaging with spectral modeling off at:blinded comparison with MR spectroscopy. Radiology 2011;258(3):767-75.

10) Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy 2013;29(3):459-70.

11) Grimberg J, Kany J, Valenti P, et al. Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears. Arthroscopy 2015;31(4):599-607.

12) Wall B, Nové-Josserand L, O'Connor DP, et al. Reverse total shoulder arthroplasty:a review of results according to etiology. J Bone Joint Surg Am. 2007;89(7):1476-85.