高频超声及肩峰下滑囊超声造影在肩袖损伤诊断中的应用价值  

Application Value of High-frequency Ultrasound and Contrast-enhanced Ultrasonography of the Bursa of the Acromion in the Diagnosis of Rotator Cuff Injury

作　　者：郝艳红[1] 刘利平[1] 张炎晶[1] 李廷廷[1] 刘静静[1] 韩晓强[2] Hao Yanhong;Liu Liping;Zhang Yanjing;Li Tingting;Liu Jingjing;Han Xiaoqiang(Department of Ultrasound,The First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Sports Medicine in Orthopedics,The First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院超声影像科,太原030001 [2]山西医科大学第一医院,太原030001

出　　处：《中国运动医学杂志》2023年第1期25-31,共7页Chinese Journal of Sports Medicine

基　　金：山西省重点研发计划项目(201903D321196)。

摘　　要：目的:探讨高频超声及经皮肩峰下滑囊超声造影在肩袖损伤中的应用价值,分析两种超声检查技术在肩袖损伤诊断中的的效能差异。方法:选取2019年3月至2021年3月我院骨科运动医学门诊临床确诊为肩袖损伤的患者42例,其中男23例、女19例。术前均行高频超声、肩峰下滑囊超声造影及磁共振成像(MRI)检查,以肩关节镜下所见作为肩袖撕裂诊断的金标准,采用受试者工作特征(ROC)曲线分析高频超声、肩峰下滑囊超声造影与MRI对不同类型肩袖损伤的诊断效能。结果:肩关节镜证实的42例患者中,肩袖损伤36例(85.71%)。其中全层撕裂15例(41.67%),高频超声诊断7例,肩峰下滑囊超声造影诊断13例,MRI诊断14例;部分撕裂21例(58.33%),高频超声诊断12例,肩峰下滑囊超声造影诊断18例,MRI诊断19例。对于全层撕裂,高频超声、肩峰下滑囊超声造影及MRI的ROC曲线下面积(AUC)分别为0.604、0.896、0.930;对于部分撕裂,高频超声、肩峰下滑囊超声造影及MRI的AUC分别为0.643、0.905、0.929;对于无撕裂,高频超声、肩峰下滑囊超声造影及MRI的AUC分别为0.653、0.972、0.903。高频超声、肩峰下滑囊超声造影、MRI对肩袖全层撕裂(χ2=14.649,P<0.01)、部分撕裂(χ2=14.649,P<0.01)及无撕裂(χ2=10.286,P<0.01)肩袖损伤的诊断价值有差异。高频超声与肩峰下滑囊超声造影及MRI均存在统计学差异,而肩峰下滑囊超声造影与MRI对肩袖损伤的诊断价值没有统计学差异。结论:肩峰下滑囊超声造影对肩袖损伤的诊断效能优于高频超声;且肩峰下滑囊超声造影与MRI检查相比具有同等诊断效能,可作为术前肩袖损伤的评估方法。Objective To explore the value of high-frequency ultrasound and contrast-enhanced ultrasonography of the bursa of the acromion in the diagnosis of rotator cuff injury,and compare their differences. Methods Forty-two patients(23 males and 19 females) with rotator cuff injury between March2019 and March 2021 were selected. All of them underwent high-frequency ultrasound,contrast-enhanced ultrasound and MRI before operation. The shoulder arthroscopy was used as the gold standard in diagnosing rotator cuff injury, the receiver operating characteristic(ROC) curve was employed to compare the efficacy of these three techniques in the diagnosis of rotator cuff injury. Results Rotator cuff injury was found in 36(85.71%) of the 42 patients diagnosed according to their shoulder arthroscopy. Moreover, 15(41.67%), 7, 13 and 14 cases were found of full-layer tears, according to the shoulder arthroscopy,high-frequency ultrasound,contrast-enhanced ultrasonography of the acromial bursa and MRI,respectively. For 21 cases(58.33%) of partial tears according to the golden standard,12,18 and 19 cases were confirmed by high-frequency ultrasound,contrast-enhanced ultrasonography of the acromial bursa and MRI,respectively. For full-layer tear,the area under ROC curve(AUC) of high-frequency ultrasound,contra-enhanced ultrasound and MRI were 0.604,0.896 and 0.930,respectively,while for the partial tear,the corresponding values were 0.643,0.905 and 0.929,respectively.For those without tears,the corresponding values were 0.653,0.972 and 0.903,respectively. There were significant differences in the diagnostic value of high-frequency ultrasound,contrast-enhanced ultrasonography of the acromial bursa and MRI in the full-thickness tear(χ~2=14.649,P<0.01),partialthickness tear(χ~2=14.649,P<0.01) and non lacerated rotator cuff injuries(χ~2=10.286,P<0.01). There was significant difference between high-frequency ultrasound and contrast-enhanced ultrasonography of the acromial bursa or MRI in the diagnosis of rotator cuff injury,but no significant

关 键 词：高频超声 肩峰下滑囊超声造影 肩袖损伤 MRI 肩关节镜 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686[医药卫生—诊断学]