肩袖损伤的MRI扫描序列最佳组合探讨  

Study on best combination sequences of MRI for shoulder cuff injury

作　　者：陈富珍[1] 杜立新 李顶夫[1] 吕嘉玲[1] 王未[1] 

机构地区：[1]深圳大学第一附属医院放射科,广东518035 [2]深圳市龙华新区中心医院放射科,广东518110

出　　处：《齐齐哈尔医学院学报》2015年第10期1419-1422,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨肩关节肩袖损伤的MRI扫描序列最佳组合的影像诊断价值。方法前瞻性的分析对经关节镜下手术证实的38例临床资料完整的病例行MRI扫描序列常规组合及最佳组合来判定有无肩袖损伤以及各自的准确性、敏感性、特异性,在MRI扫描序列常规组合t2-blade-cor-fs-256,t2-me2d-cor(2D-MEDIC技术)t2-me2d-tra(2D-MEDIC技术),t2-me2d-sag(2D-MEDIC技术)的基础上将t2-me2d-sag(2D-MEDIC技术)序列改为t2-me3d-sag-fs-2mm(3D-MEDIC技术及脂肪抑制技术)组成的序列最佳组合与肩关节镜下手术对比,从而来判定序列最佳组合对肩袖损伤的价值。结果肩袖损伤的38例患者组成肩袖主要各肌肉及其肌腱损伤共152个病变中经肩关节镜下手术证实:其中冈上肌损伤及冈上肌腱撕裂损伤27个病变,冈下肌及肌腱损伤14个病变,肩胛下肌及肌腱损伤16个病变,小圆肌损伤1个病变。肩袖损伤的MRI扫描序列最佳组合与常规组合对肩袖损伤的敏感性分别为86.56%及77.33%,特异性分别为95.29%及76.66%,准确性分别为91.44%及76.97%。与镜下手术对比,MRI扫描序列最佳组合对肩袖损伤的诊断价值无明显统计学差异(P>0.05)。结论肩袖损伤MRI扫描序列最佳组合的检查方法,对组成肩袖各肌肉及肌腱都显示清晰、完整、准确性高,是肩关节准确、可靠、实用的MRI检查扫描技术。对临床术前及术后的评估具有指导性作用及较高的临床价值。因此我们运用MRI扫描序列常规组合外,另将t2-me2d-sag改为t2-me3d-sag-fs-2mm(3D-MEDIC技术及脂肪抑制技术)组成的MRI扫描序列最佳组合,增加了检出率,准确性、敏感性、特异性都大大的提高,给临床对肩袖损伤的治疗具有指导意义。Objective To investigate the image diagnostic value of the best combination of MRI scanning sequences for rotator cuff injury of shoulder. Methods Applied prospective analysis for the general MRI scanning routine and for the best sequence-combination to determine accuracy,sensitive and specificity of shoulder cuff injury for the 38 patients who were confirmed by arthroscopy with integrated clinical data. Based on the general routine which was composed of t2-blade-cor-fs-256,t2-me2d-cor（ 2D-MEDIC technique）,t2-me2dtra（ 2D-MEDIC technique） and t2-me2d-sag（ 2D-MEDIC technique）,the t2-me3d-sag-fs-2mm（ 3D-MEDIC and fat saturated technique） was used instead of t2-me2d-sag（ 2D-MEDIC technique） for the best combination.The value of this combination was investigated compared with shoulder arthroscopy. Results 152 lesions of the muscle and tendon in shoulder cuff were confirmed by shoulder arthroscopy for the 38 patients,including 27 lesions of supraspinatus,14 lesions of infraspinatus,16 lesions of subscapular muscle,and 1 lesion of teres minor. The sensibility of the best combination of sequences and the general MRI routine for shoulder cuff injury were 86. 56% and 77. 33% respectively; the specificity were 95. 59% and 76. 66% respectively; and the accuracy were 91. 44% and 76. 97% respectively. There was no significant statistical difference（ P〉0. 05） for diagnostic value of the best combination of sequences compared with arthroscopy. Conclusions The best combination of sequences for shoulder cuff injury was accurate,reliable and practical MRI scanning technique because the muscle and tendon of the shoulder cuff was displayed distinctly,perfectly and precisely. The combination took the guidance and had superior clinical value for the assessments before and after operations.Therefore,the best combination of sequences with t2-me3d-sag-fs-2mm（ 3D-MEDIC and fat saturated technique）instead of t2-me2d-sag besides the general routine increased detective efficiency,veracity,sensitivity,and specific

关 键 词：肩关节 肩袖 损伤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]