肩袖撕裂MRI诊断与临床诊断的比较研究  

Comparative Study on Diagnoses of Rotator Cuff Tear by MRI and Clinical Examination

作　　者：张宇[1] 张祯铭[2] 杨海山[2] 

机构地区：[1]沈阳体育学院运动人体科学学院,辽宁沈阳110102 [2]吉林大学中日联谊医院放射科,吉林长春130033

出　　处：《广州体育学院学报》2014年第2期89-91,112,共4页Journal of Guangzhou Sport University

摘　　要：目的:探讨临床检查和磁共振成像(MRI)对肩袖撕裂的诊断价值。方法:对32例疑似肩袖撕裂患者进行临床检查和MRI检查,后进行关节镜手术检查。以关节镜检查结果为标准,对临床检查和MRI检查诊断肩袖撕裂的结果进行比较分析。结果:关节镜检查发现肩袖撕裂22例,正常10例。以肩关节镜下所见为标准,临床检查诊断肩袖撕裂的敏感性、特异性、准确性分别为86.4%、50%、75%。MRI检查诊断肩袖撕裂的敏感性、特异性、准确性分别为86.4%、70%、81.2%。在关节镜证实肩袖撕裂22例患者中,临床检查阳性率较高的有大结节压痛20例(90.9%),疼痛弧征19例(86.4%),撞击试验17例(77.3%),肩坠落试验14例(63.6%)。结论:MRI诊断对肩袖撕裂的诊断和分级的准确性较高,是诊断肩袖撕裂的有效方法。临床诊断对肩部疼痛的患者及时进行临床检查有重要意义,是诊断肩袖撕裂的基本方法;两种诊断方法的敏感性一致,MRI对肩袖撕裂诊断的特异性和准确性均优于临床诊断。Objective To evaluate the role of MRI and the clinical examination in diagnosing rotator cuff tear. Methods Clinical diagnoses of 32 cases who suspected suffered from rotator cuff tear were compared with that of subsequent MRI. The results of clinical diagnosis and that of MRI diagnosis were analysed according to the arthroscopic finding. Results 22 cases of rotator cuff tear and 10cases of normal rotator cuff were diagnosed through arthroscopy. Arthroscopic examination was used as evaluating standard, the sensitivity, specificity and accuracy for clinical diagnosis were 86.4% ,50% ,75% respectively, and for MRI were 86.4% ,70% ,81.2% respectively. Arthroscopy diagnoses of 22 cases who suffered from rotator cuff tear, signs higher positive rate consisted of painful were in 20（90.9% ）, painful arc were in 19 （86.4%）, impingement sign were in 17 （77. 3% ） , arm drop sign were in 14（63.6% ）. Conclusion In rotator cuff tear, clinical diagnosis showed a lower specificity, while MRI showed a higher sensitivity, specificity and accuracy .

关 键 词：肩袖 临床诊断 磁共振成像 

分 类 号：G804.63[文化科学—运动人体科学]