剪切波超声弹性成像对冈上肌腱滑囊侧部分撕裂的诊断价值分析  

Diagnostic value of shear wave elastography for partial tear of supraspinatus tendon bursa

作　　者：黄家兴 王家炜 朱博 蒲大容[2] 胡宁[1] 陈虹[1] HUANG Jiaxing;WANG Jiawei;ZHU Bo;PU Darong;HU Ning;CHEN Hong(Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Ultrasound Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院骨科,400016 [2]重庆医科大学附属第一医院超声医学科,400016

出　　处：《重庆医学》2022年第18期3100-3104,3110,共6页Chongqing medicine

基　　金：重庆市科卫联合医学科研项目(2021MSXM032)。

摘　　要：目的探究剪切波超声弹性成像(SWE)对于冈上肌腱滑囊侧部分撕裂的诊断价值,并比较其与磁共振成像(MRI)及二维超声对冈上肌腱滑囊侧部分撕裂的诊断价值差异。方法选取该院骨科行肩关节镜手术的62例患者为研究对象,根据有无肩袖损伤分为无撕裂组(24例)和部分撕裂组(38例)。术前行肩关节MRI、SWE测定及肩关节超声。定量测定双侧冈上肌腱与肌腹的杨氏模量,与对侧进行比较,受试者工作特征(ROC)曲线分析对冈上肌腱侧部分撕裂的诊断效能。结果与无撕裂组比较,部分撕裂组术侧冈上肌腱SWE值明显升高,且两组术侧冈上肌腱SWE值较对侧升高,差异有统计学意义(P<0.05)。当术侧较对侧的SWE变化值δSWE为20.36 kPa时,诊断部分撕裂的灵敏度为84.2%,特异度为100.0%,高于MRI(P=0.0029)及二维超声(P=0.0019)。结论SWE测定对冈上肌腱部分撕裂诊断具有应用价值。Objective To explore the diagnostic value of shear wave elastography(SWE)for partial tear of supraspinatus tendon bursa and compare its value with two-dimensional ultrasound and magnetic resonance imaging(MRI)for supraspinatus tendon bursa side partial tear.Methods A total of 62 patients who underwent arthroscopic shoulder surgery in the department of orthopedics of this hospital were selected as the research objects.According to whether there was rotator cuff injury or not,they were divided into two groups:the no tear group(24 cases)and the partial tear group(38 cases).MRI,SWE,and ultrasound were performed before the operation.The elasticity modulus of supraspinatus tendon and muscle belly were measured in the affected and contra-lateral normal shoulder.Compared with that of the opposite side,receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of lateral supraspinatus tendon tear.Results Compared with the no tear group,the SWE value of the supraspinatus tendon in the partial tear group was significantly increased,and the SWE value of the supraspinatus tendon on the operative side in the two groups was higher than that in the opposite side,the difference was statistically significant(P<0.05).When the SWE change value(δSWE)of the supraspinatus tendon on the operative side was 20.36 kPa higher than that on the opposite side,the diagnostic sensitivity reached 84.2%,with a specificity of 100.0%,which was significantly higher than MRI(P=0.0029)and two-dimensional ultrasound(P=0.0019).Conclusion SWE measurement has application value in the diagnosis of supraspinatus tendon tear.

关 键 词：冈上肌腱部分撕裂 肩袖损伤 超声 剪切波弹性成像 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]