3.0T磁共振评价冈上肌肌腱炎和肌腱撕裂量化分级的可靠性研究  

Reliability of 3.0T Magnetic Resonance Imaging Evaluation of Supraspinatus Tendinitis and Tendon Tear Quantitative Grading

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,the Fifth Central Hospital of Tianjin,Tianjin 300450,Chin)

机构地区：[1]天津市第五中心医院放射科,天津300450

出　　处：《解放军预防医学杂志》2018年第6期738-741,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的探讨冈上肌肌腱炎及肌腱部分厚度撕裂的磁共振量化分级及其内部观察者和观察者间的可靠性。方法选取80例冈上肌撕裂或肩峰下撞击综合征患者行3.0T磁共振检查,由三名独立有经验的肌肉骨骼系统放射科医师进行评价,包括肌腱炎(无、局灶、弥漫性),部分厚度撕裂(无、0%~25%、26%~50%、51%~100%和全层撕裂)和前后撕裂(<5 mm、5~10 mm、>10 mm)。每一名放射科医生选取两个不同时间(T1,T2,间隔2个月)采集数据并分析每个数值帧间和帧内的Kappa加权值。结果内部观察者加权Kappa值:肌腱炎为0.83~0.91;部分厚度撕裂为0.82;前后撕裂为0.72~0.82;总评分为0.82~0.84。在两个时间点(T1,T2)观察者间加权Kappa值:肌腱炎为0.55~0.73;部分厚度撕裂为0.63~0.83;前后撕裂为0.57~0.79;总评分为0.61~0.80。结论 MRI多参数量化评分系统评价冈上肌肌腱炎和部分厚度肌腱撕裂有极佳的Kappa值相关性,同时肩袖磁共振成像可以评估不同治疗方式下肌腱形态学变化。Objective To study the reliability of assessment of supraspinatus tendinitis and tendon tear with MRI grading.Methods A total of 80 cases of supraspinatus tear or subacromial impingement syndrome underwent 3. 0 T MRI. Three independent and experienced musculoskeletal radiologists evaluated the results of examination,Including tendinitis（ no,focal and diffuse）,partial thickness tear（ no,0%-25%,25%-50%,50%-100%,and full-thickness tear and tear）,anterior and posterior tear（ less than 5 mm,5-10 mm,more than 10 mm）. Each of the three radiologists collected the data and calculated the weighted values within each inter frame and intra frame at two different time points（ T1,T2,at an interval of 2 months）. Results The intra observer＇s weighted Kappa value： 0. 83-0. 91 for tendinitis,0. 82 for partial thickness tear,0. 72-0. 82 for anterior and posterior tear,and the total score was 0. 82-0. 84,compared to 0. 55-0. 73,0. 63-0. 83,0. 57-0. 70 and 0. 61-0. 80 by the inter observer. Conclusion There is a good correlation between evaluation of supraspinatus tendinitis and tendon tear using quantitative grading of MRI and Kappa values. At the same time,magnetic resonance imaging of rotator cuff injuries can be used to evaluate the changes of tendon morphology under different treatments.

关 键 词：部分厚度冈上肌撕裂 肌腱病变 肌腱 肩袖 磁共振 

分 类 号：R445.2[医药卫生—影像医学与核医学]