复发性肩关节不稳定的MRA诊断价值研究  

Study on the Value of MRA in Recurrent Shoulder Instability

作　　者：唐光华 黄建国 周军 赖昌斌 江长青[2] TANG Guanghua;HUANG Jianguo;ZHOU Jun;LAI Changbin;JIANG Changqing(Sanhe Hospital of Huiyang,Huizhou 517211,China;不详)

机构地区：[1]惠阳三和医院,广东惠州517211 [2]北京大学深圳医院

出　　处：《中外医学研究》2020年第18期58-60,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：惠州市科技计划项目(180508191742179)。

摘　　要：目的:探讨MRA对复发性肩关节不稳定的诊断价值。方法:于2018年1月-2019年12月惠阳三和医院及北京大学深圳医院运动医学科中选取符合纳入标准患者59例,均行MRA检查及肩关节镜检查。以肩关节镜检查结果为"金标准",观察MRA诊断肩关节不稳中Bankart损伤、肩袖损伤、盂唇撕裂、Hill-sachs损伤的敏感度、特异度、准确度及约登指数,并以Kappa值评估MRA诊断与肩关节镜诊断的一致性。结果:MRA诊断肩关节Bankart损伤的敏感度、特异度、准确度分别为87.5%、90.7%、89.8%;MRA诊断肩关节肩袖损伤的敏感度、特异度、准确度分别为92.3%、86.9%、88.1%;MRA诊断肩关节盂唇撕裂的敏感度、特异度、准确度分别为90.5%、89.5%、89.8%;MRA诊断肩关节Hill-sachs损伤的敏感度、特异度、准确度分别为100%、90.0%、91.5%。MRA诊断肩关节不稳定的约登指数由高至低依次为Hill-sachs损伤(0.900)、盂唇撕裂(0.800)、肩袖损伤(0.792)、Bankart损伤(0.782)。MRA诊断Hill-sachs损伤、盂唇撕裂、肩袖损伤、Bankart损伤与肩关节镜诊断结果一致性较高(Kappa≥0.75,P<0.05)。结论:MRA检查对复发性肩关节不稳定的诊断效果显著,尤其是对Hill-sachs损伤、盂唇撕裂、肩袖损伤、Bankart损伤具有较高的诊断效能,值得临床推广应用。Objective:To explore the value of MRA in the diagnosis of recurrent shoulder instability.Method:From January 2018 to December 2019,59 patients who met the inclusion criteria in the Department of Sports Medicine of Sanhe Hospital of Huiyang and Peking University Shenzhen Hospital were selected,all of whom underwent MRA and shoulder arthroscopy.The result of shoulder arthroscopy was set as gold standard.The sensitivity,specificity,accuracy and Yoden index of MRA in the diagnosis of Bankart injury,rotator cuff injury,glenoid lip tear and Hill-sachs injury were observed.Kappa value was used to evaluate the consistency between MRA and shoulder arthroscopy.Result:The sensitivity,specificity and accuracy of MRA in the diagnosis of Bankart injury were 87.5%,90.7%and 89.8%respectively.The sensitivity,specificity and accuracy of MRA in the diagnosis of rotator cuff injury were 92.3%,86.9%and 88.1%respectively.The sensitivity,specificity and accuracy of MRA in the diagnosis of glenoid lip tear were 90.5%,89.5%and 89.8%respectively.The sensitivity,specificity and accuracy of MRA in the diagnosis of Hill-sachs injury were 100%,90.0%and 91.5%respectively.From high to low,Yoden index of MRA in the diagnosis of shoulder instability was Hill-sachs injury(0.900),glenoid lip tear(0.800),rotator cuff injury(0.792)and Bankart injury(0.782).The results of MRA in the diagnosis of Hill-sachs injury,glenoid lip tear,rotator cuff injury,Bankart injury had high consistency with those of shoulder arthroscopy(Kappa≥0.75,P<0.05).Conclusion:MRA has a significant diagnostic effect on the shoulder instability,especially for Hill-sachs injury,glenoid lip tear,rotator cuff injury and Bankart injury,which is worthy of clinical application.

关 键 词：复发性肩关节不稳定 MRA 肩关节镜 诊断价值 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]