目的 分析核磁共振成像(MRI) 优化组合序列在肩周炎与肩袖损伤诊断 中的价值。方法 回顾性分析我院2015年 5月-2017年5月期间收治的经关节镜检查 确诊为肩周炎或肩袖损伤69例患者的临床 资料，采用GE 1.5T MRI机和关节线圈， 进行常规序列和优化组合序列扫描，包 括横轴位、斜冠状位和斜矢状位，观察 关节损伤情况、损伤范围和程度等，进 行肩周炎和肩袖损伤的诊断。结果 共69 例患者中，关节镜诊断结果为肩周炎22 例，肩袖损伤47例；MRI优化组合序列诊 断肩周炎的正确率为97.10%(67/69)， 灵敏度为95.45%(21/22)，特异度为 97.87%(46/47)；MRI优化组合序列诊断 肩袖损伤的正确率为98.55%(68/69)， 灵敏度为97.87%(46/47)，特异度为 100%(22/22)；T1WI与T2WI-STIR序列阳性 检出率间存在显著差异(P<0.05)，优化序 列扫描结果显示，冈上肌腱斜冠状位、斜 矢状位及横轴位T2WI-STIR序列显示阳性 检出率较佳，冈下肌腱斜冠状位及横轴位 T2WI-STIR序列显示阳性检出率较佳，小 圆肌腱及肩胛下肌腱横轴位T1WI+T2WISTIR序列显示阳性检出率较佳。结论 MRI 是临床诊断肩周炎、肩袖损伤的重要手 段，优化组合序列扫描可反映不同的病理 特征，更有助于提高诊断正确率。

Objective To analyze the values of magnetic resonance imaging (MRI) optimization sequence in the diagnosis of scapulohumeral periarthritis and rotator cuff injury. Methods The clinical data of 69 cases of patients with scapulohumeral periarthritis or rotator cuff injury diagnosed by arthroscopy in our hospital from May 2015 to May 2017 were analyzed retrospectively. The GE 1.5T MRI and joint coils were used to carry out the scanning of routine sequence and optimization sequence, including transverse axial, oblique coronal and oblique sagittal positions. The joint injury, the degree and range of injury were observed to perform the diagnosis of scapulohumeral periarthritis and rotator cuff injury. Results Among 69 cases of patients, there were 22 cases of scapulohumeral periarthritis and 47 cases of rotator cuff injury by arthroscopic diagnosis. The accuracy rate, the sensitivity and the specificity were 97.10% (67/69), 95.45% (21/22) and 97.87% (46/47) of MRI optimization sequence in the diagnosis of scapulohumeral periarthritis and were 98.55% (68/69), 97.87% (46/47) and 100% (22/22) of MRI optimization sequence in the diagnosis of rotator cuff injury. There were significant differences in the positive detection rate between T1WI and T2WI-STIR sequences (P<0.05), and the results of optimization sequence scanning showed that the positive detection rate was good in the supraspinatus tendon oblique coronal, oblique sagittal and transverse axial T2WI-STIR sequences, and the positive detection rate was good in the posterior supraspinatus tendon oblique coronal and transverse axial T2WI-STIR sequences, and the positive detection rate was good in the telescope tendon and subscapular tendon transverse axial T1WI T2WI-STIR sequences. Conclusion MRI is an important method for clinical diagnosis of scapulohumeral periarthritis and rotator cuff injury. The optimization sequence scanning can reflect different pathological features and help to improve diagnostic accuracy.