超声与磁共振在中老年部分肩袖损伤诊断中的对比  

Comparison of ultrasound and MRI in the diagnosis of partial rotator cuff injury in middle-aged and elderly patients

作　　者：王逸乐 陈先进[2] 钱利海[2] WANG Yile;CHEN Xianjin;QIAN Lihai(Department I of Joint,Postgraduate Training Base in Wuhu,Anhui University of Chinese Medicine,Wuhu 241000,China;Department I of Joint,Wuhu Hospital of Traditional Chinese Medicine in Anhui Province,Wuhu 241000,China)

机构地区：[1]安徽中医药大学芜湖市中医医院研究生培养基地关节一科,安徽芜湖241000 [2]安徽省芜湖市中医医院关节一科,安徽芜湖241000

出　　处：《中国现代医生》2022年第11期135-139,共5页China Modern Doctor

摘　　要：目的探讨超声及MRI在中老年肩袖部分撕裂诊断中的优劣,结合临床结果对比其诊断价值。方法选取2020年1月至2021年6月安徽省芜湖市中医院住院治疗的中老年部分肩袖撕裂患者33例纳入研究。以肩关节镜的诊断结果为金标准。所有患者术前行肩部超声和肩部MRI检查。比较超声与MRI对肩袖部分撕裂的敏感度、特异度及准确度。结果金标准肩关节镜发现阳性患者26例,阴性患者7例。超声发现阳性患者24例,其中有21例为真阳性患者。超声诊断阴性患者9例。超声对部分肩袖损伤的敏感度为80.8%(21/26),特异度为57.1%(4/7),准确度为75.8%(25/33)。MRI发现阳性患者26例,其中真阳性患者24例;发现阴性患者7例。MRI对部分肩袖损伤的敏感度为92.3%(24/26),特异度为71.3%(5/7),准确度为87.9%(29/33)。结论超声与磁共振对于中老年部分肩袖损伤的诊断效能(准确度、特异度、敏感度)并无绝对优劣。应根据患者情况(经济情况、体内有无内固定物、是否需要双侧对比、是否需要动态检查)合理选择MRI和超声检查。Objective To investigate the advantages and disadvantages of ultrasound and magnetic resonance imaging(MRI)in the diagnosis of partial rotator cuff injury in middle-aged and elderly patients,and to compare their diagnostic values based on clinical results.Methods A total of 33 middle-aged and elderly patients with partial rotator cuff injury who were hospitalized in Wuhu Hospital of Traditional Chinese Medicine in Anhui Province from January 2020 to June 2021 were selected and included in this study.The diagnostic results of shoulder arthroscopy were used as the gold standard.All patients underwent shoulder ultrasound and shoulder MRI before surgery.The sensitivity,specificity and accuracy of ultrasound and MRI for partial rotator cuff injury were compared.Results There were 26 patients diagnosed positive and 7 patients diagnosed negative by shoulder arthroscopy(the gold standard).24 patients were diagnosed positive by ultrasound,of which 21 patients were true positives,and 9 patients were diagnosed negative by ultrasound.The sensitivity,specificity and accuracy of ultrasound for partial rotator cuff injury were 80.8%(21/26),57.1%(4/7)and 75.8%(25/33),respectively.26 patients were diagnosed positive by MRI,of which 24 patients were true positives,and 7 patients were diagnosed negative by MRI.The sensitivity,specificity and accuracy of MRI for partial rotator cuff injury were 92.3%(24/26),71.3%(5/7)and 87.9%(29/33),respectively.Conclusion For middle-aged and elderly patients with partial rotator cuff tears,ultrasound and magnetic resonance imaging have no absolute advantages or disadvantages in the diagnosis of intermediate and elderly partial rotator cuff injuries(accuracy,specificity,sensitivity).MRI and ultrasonography should be reasonably selected based on the patient′s condition(economic situation,internal fixations in the body,need for bilateral contrast,whether dynamic examination is required).

关 键 词：肩袖部分撕裂 超声 磁共振 关节镜手术 

分 类 号：R445[医药卫生—影像医学与核医学] R658.2[医药卫生—诊断学]