肩关节损伤的MR关节造影与MRI对比研究  

Comparative study of MR arthrography and MRI in shoulder joint injuries

作　　者：刘圣源[1] 于晓坤[1] 高宗辉[1] 张乐[1] LIU Shengyuan;YU Xiaokun;GAO Zonghui;ZHANG Le(Department of Radiology,Tianjin the Fifth Center Hospital,Tianjin 300450,P.R.Chin)

机构地区：[1]天津市第五中心医院放射科,天津300450

出　　处：《医学影像学杂志》2018年第7期1187-1190,1195,共5页Journal of Medical Imaging

摘　　要：目的探讨肩关节MR关节造影与常规MRI检查阳性率的敏感性及特异性,并探讨哪类患者更适用于MR关节造影。方法选取100例肩痛患者先后行肩关节常规MRI和MR关节造影检查,图像分别由两位有经验的放射医师盲法评价,评估盂唇撕裂和冈上肌肌腱撕裂;所有患者均行关节镜检查并与MRI及MR关节造影结果分别做对照分析。结果 100例患者中,在常规MRI检查评价者1中共有43例上盂唇前后(SLAP)撕裂,28例后盂唇撕裂,23例前盂唇撕裂和47例冈上肌肌腱撕裂;评价者2中有42例SLAP撕裂,26例后盂唇撕裂,24例前盂唇撕裂和47例冈上肌肌腱撕裂。在MR关节造影检查评价者1中有51例SLAP撕裂,33例后盂唇撕裂,29例前盂唇撕裂和49例冈上肌肌腱撕裂;评价者2中有50例SLAP撕裂,31例后盂唇撕裂,30例前盂唇撕裂和49例冈上肌肌腱撕裂。MR关节造影评价者1和2中均额外发现8例SLAP撕裂,5例后盂唇撕裂,6例前盂唇撕裂和2例冈上肌肌腱撕裂,而这些在常规MRI检查中均未发现。48例常规MRI检查正常中有21例在MR关节造影检查中发现额外异常;52例患者常规MR检查异常中仅有3例在MR关节造影检查中发现额外异常结果。结论常规MRI检查异常时再行MR关节造影检查能显示的额外阳性信息很少,这类患者可不需要MR关节造影检查;常规MRI检查为阴性患者再行MR关节造影检查可发现额外异常结果。Objective To investigate the sensitivity and specificity of MR arthrography and conventional MRI in shoulder joint and to determine which groups need to perform MR arthrography after routine MRI scans.Methods 100 consecutive conventional shoulder MR and MR arthrography examinations performed on the same patients were reviewed retrospectively by independent reading of 2 radiologists. Conventional MR and MR arthrogram examinations were assessed for labral tears and supraspinatus tendon tears.Control study was conducted with arthroscopy.Results Of these 100 patients, 43 patients had superior labral anterior to posterior （SLAP） tears, 28 patients had posterior labral tears, 23 patients had anterior labral tears and 47 patients had full-thickness supraspinatus tendon tears on conventional MRexamination reading by Reader 1. There were 42 SLAP tears, 26 posterior labral tears, 24 anterior labral tears and 47 full-thickness supraspinatus tendon tears on conventional MR examination read by Reader 2. On MR arthrogram examination, 51 patients had SLAP tears, 33 patients had posterior labral tears, 29 patients had anterior labral tears and 49 patients had full-thickness supraspinatus tendon tears on reading by Reader 1. On MR arthrogram examination, 50 patients had SLAP tears, 31 patients had posterior labral tears, 30 patients had anterior labral tears and 49 patients had full-thickness supraspinatus tendon tears read by Reader 2. MR arthrogram detected eight SLAP tears, five posterior labral tears, six anterior labral tears and two supraspinatus tendon tears not detected on conventional MR examination read by Reader 1. MR arthrogram detected eight SLAP tears, five posterior labral tears, six anterior labral tears and two supraspinatus tendon tears not detected on conventional MR examination read by Reader 2. 21 of the 48 patients with additional finding on MR arthrogram examination had normal appearing conventional MR examinations. 52 patients had abnormalities in routine MR examinations, with only 3 additional abno

关 键 词：上盂唇前后纵向撕裂 盂唇撕裂 冈上肌肌腱撕裂 磁共振关节造影 磁共振成像 

分 类 号：R686.1[医药卫生—骨科学] R445.2[医药卫生—外科学]