MRI sign of venous varicosity aids in diagnosis of quadrilateral space syndrome: A comparative study

IF 3.9 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI:10.1016/j.ejrad.2026.112716

Li Ying , Dawei Han , Liwei Ying , Danxiu Wang , Zilong Wang , Tao-Hsin Tung , Xiaobo Zhou , Qingguo Zhang

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引用次数: 0

Abstract

Background

The diagnosis of quadrilateral space syndrome (QSS) is difficult due to its vague symptoms and lacking of simple imaging signs. This study aimed to assess the diagnostic value of venous varicosity as an indirect MRI marker for QSS.

Methods

Two blinded independent observers compared MRI findings of venous varicosity at quadrilateral space between QSS patients and controls. Consecutive QSS patients from July 2023 to July 2024 were included. Consecutive normal subjects from January 2020 to July 2024 and rotator cuff tear patients from June 2024 to July 2024 were included in control group. Venous tortuosity, engorgement, and maximum venous diameter, were evaluated on coronal and sagittal slices. Tortuous and engorged veins were recognized as varicosities.

Study design: retrospective comparative study; level of evidence, 3.

Results

A total of 31 QSS patients were compared to 119 control subjects. The intraclass correlation coefficient (ICC) of intra-rater reliability for the first observer was 0.90 (95% CI, 0.85–0.94; p < 0.001) for venous tortuosity and 0.96 (95% CI, 0.93–0.98; p < 0.001) for venous engorgement. The ICC of intra-rater reliability for the second observer was 0.85 (95% CI, 0.78–0.90; p < 0.001) for venous tortuosity and 0.92 (95% CI, 0.87–0.95; p < 0.001) for venous engorgement. The ICC of inter-rater reliability was 0.85 (95% CI, 0.77–0.90; p < 0.001) for venous tortuosity and 0.82 (95% CI, 0.72–0.88; p < 0.001) for venous engorgement. There was significant difference in maximum venous diameter between QSS group and control group (3.0 ± 0.7 mm vs. 2.2 ± 0.5 mm, p < 0.001).

Conclusion

Venous varicosity posterior to the quadrilateral space on MRI is a simple and specific sign aiding in diagnosis of QSS.

查看原文本刊更多论文

静脉曲张MRI征象对四边形间隙综合征诊断的比较研究。

背景：四边形间隙综合征（quadrilateral space syndrome， QSS）症状模糊，缺乏简单的影像学征象，诊断困难。本研究旨在评估静脉曲张作为QSS的间接MRI标志物的诊断价值。方法：两名独立的盲法观察者比较QSS患者和对照组四边形静脉曲张的MRI表现。纳入2023年7月至2024年7月连续的QSS患者。对照组为2020年1月至2024年7月连续正常受试者和2024年6月至2024年7月肩袖撕裂患者。在冠状面和矢状面切片上评估静脉曲度、充血和最大静脉直径。弯曲和充盈的静脉被认为是静脉曲张。研究设计：回顾性比较研究；证据水平，3。结果：QSS患者31例，对照组119例。第一观察者的组内相关系数（ICC）的组内信度为0.90 （95% CI, 0.85-0.94; p）结论：MRI上四边形间隙后静脉曲张是一种简单而特异性的征象，有助于诊断QSS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.