摘要
目的:探究MRI在肩袖损伤诊断及撕裂程度的评估中的应用效果。方法:回顾性分析我院183例肩部损伤患者资料,所有患者均行核磁共振成像(MRI)检查,以关节镜检查为金标准,探究MRI对肩袖损伤的诊断价值,对肩袖不同肌腱损伤及撕裂程度的检出情况,分析MRI与关节镜测量肩袖全层撕裂肌腱撕裂尺寸偏差情况。结果:经关节镜检查,183例患者肩袖损伤阳性136例,阴性47例,MRI检查134例阳性,49例阴性,诊断敏感度95.59%(130/136),特异度91.49%(43/47),准确度为94.54%(173/183),阳性预测值为97.01%(130/134),阴性预测值87.76%(43/49),Kappa值为0.859。183例患者关节镜共诊断373处损伤,其中冈上肌腱136处,冈下肌腱122处,肩胛下肌腱115处。MRI对冈上肌腱、冈下肌腱、肩胛下肌腱的检出率显著低于关节镜检查(P<0.05);136例肩袖损伤患者中全层撕裂45例,部分撕裂91例,MRI诊断全层撕裂准确率为93.33%(42/45),部分撕裂为94.51%(86/91),总准确率为94.12%(128/136),显著低于关节镜检查(P<0.05);MRI测量全层撕裂肌腱断端回缩度、撕裂跨度的准确率分别为86.67%(39/45)、82.22%(37/45)。结论:MRI对肩袖损伤及肌腱撕裂程度均具有较高的诊断价值,可为肩袖损伤提供可靠的术前诊断依据,值得在临床推广应用。
Objective:To explore the application efficacy of MRI in diagnosing rotator cuff injury and assessing the tear degree.Methods:A retrospective analysis was conducted on the data of 183 patients with shoulder injuries in our hospital.All patients underwent a magnetic resonance imaging(MRI)examination,using arthroscopy as the gold standard to investigate the diagnostic value of MRI for rotator cuff injuries.The detection of injuries and the degree of tears in different tendons of the rotator cuff were examined,and the deviation in the measurements of tendon tear sizes in full-thickness tears by MRI compared to arthroscopy was analyzed.Results:Arthroscopic examination revealed 136 positive cases of rotator cuff injuries out of 183 patients,and 47 negative cases.MRI detected 134 positive cases and 49 negative cases,with a diagnostic sensitivity of 95.59%(130/136),specificity of 91.49%(43/47),accuracy of 94.54%(173/183),positive predictive value of 97.01%(130/134),negative predictive value of 87.76%(43/49),and a Kappa value of 0.859.Arthroscopy diagnosed a total of 373 injuries in 183 patients,including 136 supraspinatus tendon injuries,122 infraspinatus tendon injuries,and 115 subscapularis tendon injuries.The detection rate of MRI for supraspinatus,infraspinatus,and subscapularis tendon injuries was significantly lower than that of arthroscopy(P<0.05).Among the 136 patients with rotator cuff injuries,there were 45 cases of full-thickness tears and 91 cases of partial tears.The accuracy of MRI in diagnosing full-thickness tears was 93.33%(42/45)and 94.51%(86/91)for partial tears,with a total accuracy of 94.12%(128/136),which was significantly lower than that of arthroscopy(P<0.05).The accuracy of MRI in measuring the retraction degree and tear span of the tendon ends in full-thickness tears was 86.67%(39/45)and 82.22%(37/45),respectively.Conclusion:MRI has a high diagnostic value for both rotator cuff injuries and the degree of tendon tears,providing a reliable preoperative diagnostic basis for rotator cuff injuries,and is worth promoting in clinical application.
作者
潘小文
高艳
但倩
董晚亭
万趸
PAN Xiaowen;GAO Yan;DAN Qian(Sichuan Orthopedic Hospital,Sichuan Chengdu 610041,China)
出处
《河北医学》
CAS
2024年第6期951-955,共5页
Hebei Medicine
基金
四川省干部保健科科研课题项目,(编号:川干研2021-608)
2022年成都市医学科研课题,(编号:2022006)。
关键词
肩袖损伤
核磁共振成像
肩袖撕裂
肌腱
Rotator cuff injury
Magnetic resonance imaging
Rotator cuff tear
Tendon
