Summary
Ten anatomical preparations and 15 MRI scans (Magnetic Resonance Imaging) performed on healthy subjects were used to define accurately the lateral attachments and anatomical boundaries of the supraspinatus m. Using 5 frozen specimens sectioned in the plane corresponding to the sagittal oblique MRI plane, it was possible to calculate quantitatively the ratio between the bony contours (O) and muscles (M) of the supraspinous fossa. This ratio was maximal (O/M=2.4) for the section passing through the plane which included the coracoid process anteriorly and the spine of the scapula posteriorly (“Y” section). Five dissections on unembalmed subjects demonstrated that the postero-lateral origin of supraspinatus m. extended further laterally than classically described. This observation was confirmed in the 15 MRI subjects which showed that the supraspinatus m. may arise as far laterally as the “Y” section on MRI in 53% of cases. A quantitative evaluation of atrophy of the supraspinatus m. using MRI is possible with a knowledge of these two parameters.
Résumé
Dix préparations anatomiques et 15 IRM (Imagerie par Résonance Magnétique) sur sujets sains ont été utilisées pour préciser les insertions latérales du m. supra-épineux et les limites de sa loge d'insertion. Cinq préparations congelées et coupées dans le plan correspondant à celui de l'incidence sagittaleoblique de l'IRM, ont permis de calculer le rapport quantitatif entre les contours osseux (O) et musculaires (M) de la fosse supra-épineuse: ce rapport est maximal (O/M=2,4) pour une coupe passant dans le plan comprenant le processus coracoïde en avant et l'épine de la scapula en arrière (coupe en Y). Cinq dissections sur sujets non embaumés ont montré que l'insertion postéro-latérale du m. supra-épineux s'étendait latéralement au delà des insertions classiquement décrites. Cette observation a été confirmée par 15 IRM sur sujets témoins qui ont montré que le m. supra-épineux présentaient encore des insertions au niveau de la coupe IRM “en Y” dans 53 % des cas. La connaissance de ces deux paramètres permet de proposer une technique d'évaluation quantitative de l'atrophie du m. supra-épineux à l'aide de l'IRM.
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Thomazeau, H., Duval, J.M., Darnault, P. et al. Anatomical relationships and scapular attachments of the supraspinatus muscle. Surg Radiol Anat 18, 221–225 (1996). https://doi.org/10.1007/BF02346130
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DOI: https://doi.org/10.1007/BF02346130