磁共振平扫与磁共振关节造影在肩袖撕裂诊断中的应用价值  

Application value of conventional MRI and MR arthrography in the diagnosis of rotator cuff tear

作　　者：刘树学[1] 任明达[1] 肖铮[1] 吴宇峰[1] 洪云恒[1] 张雄彪[1] 唐玉德[1] 罗丽好[1] 陈志明[1] 李水连[1] 

机构地区：[1]广州中医药大学附属中山医院放射科,广东中山528400

出　　处：《实用放射学杂志》2013年第4期615-618,共4页Journal of Practical Radiology

基　　金：基金项目：中山市科技计划项目（20122A155）.

摘　　要：目的研究肩袖撕裂的磁共振平扫（MRI）及磁共振关节造影（MRarthrography）的影像学特征，探讨2种方法在肩袖撕裂诊断中的价值；探索磁共振关节造影的检查适应证。方法79例经肩关节镜或切开手术证实的肩袖撕裂病人，根据术中所见将肩袖撕裂分为5型，回顾性分析肩袖撕裂病人的MRI平扫及造影征象，对各型肩袖撕裂诊断的准确性进行比较分析。结果I型肩袖撕裂18例，MRI平扫及造影均能做出正确诊断（18／18）；1I型肩袖撕裂18例，MRI平扫诊断16例（16／18），关节造影诊断18例（18／18）；1II型肩袖撕裂7例，MRI平扫诊断7例（7／7），关节造影诊断0例；Ⅳ型肩袖撕裂22例，MRI平扫诊断16例（16／22），关节造影诊断22例（22／22）；V型肩袖撕裂14例，MRI平扫诊断14例（14／14），关节造影诊断。例。结论磁共振平扫能够对大部分肩袖撕裂做出正确诊断，但对于Ⅱ型及Ⅳ型肩袖撕裂诊断不够准确，存在假阳性及假阴性；磁共振肩关节造影对于Ⅱ型及Ⅳ型肩袖撕裂的诊断具有重要价值，能够确定诊断，但对于Ⅲ型及V型肩袖撕裂的诊断没有帮助；磁共振肩关节检查，应该首先选择常规磁共振检查，对于平扫不能确定的、可疑Ⅱ型及Ⅳ型肩袖撕裂的病人可选择进行磁共振关节造影检查。Objective To study the imaging features of conventional MRI and MR arthrography{MRA） of rotator cuff tear, eval- uate the value of these two techniques,and explore the indications of MRA . Methods 79 cases with rotator cuff tear confirmed by arthroseopie or surgery were divided into five types according to the intraoperative findings, Image features of conventional MRI and MRA of rotator cuff tear were retrospectively analysed,and the sensitivity and specificity of the two techniques for various rotator cuff tears were comparated. Results Type I rotator cuff tear was showed in 18 cases, the two methods all made the right diagnosis （accuracy rate of 100 % ） ; type I] rotator cuff tear in 18 cases, conventional MRI correctly diagnosed 16 cases（ accuracy rate of 89 ~ }, MRA correctly diagnosed 18 cases{accuracy rate of 100%）; type l]] rotator cuff tear in 7 cases, conventional MRI correctly diag- nosed 7 cases（ accuracy rate of 100 ~ }, MRA correctly diagnosed 0 case; type 1V rotator cuff tear in 22 cases, conventional MRI cor- rectly diagnosed 16 cases{ accuracy rate of 73%） , MRA correctly diagnosed 22 cases{ accuracy rate of 100% } ; typeV rotator cuff tear in 14 cases, conventional MRI correctly diagnosed 14 cases{accuracy rate of 100% ）, MRA correctly diagnosed 0 case. Conclusion Conventional MRI can make the right diagnosis for most cases of rotator cuff tear, but not accurate enough for the diagnosis of type [] and type 1V rotator cuff tear, there are some false positive and false negative dianosis;the MRA has an important value for the diagnosis of type ]] and type IV rotator cuff tear, but it does not help the diagnosis of type I]] and type V rotator cuff tear; magnetic resonance shoulder check should first select the conventional MRI. If a suspicious rotator cuff tear is not determined on conventional MRI, MRA should be performed to diagnose type l] and type IV rotator cuff tear.

关 键 词：肩袖 撕裂 磁共振成像 关节造影术 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]