MSCT联合MRI在肩关节损伤诊断及损伤程度判定方面的价值  

The value of MSCT combined with MRI in the diagnosis and severity determination of shoulder joint injury

作　　者：曲博 石向明 王成健 张玉 霍英杰 张翔辰 QU Bo;SHI Xiang-ming;WANG Cheng-jian;ZHANG Yu;HUO Ying-jie;ZHANG Xiang-chen(Department of Imaging,Hebei Petro China Central Hospital,Langfang 065000,China)

机构地区：[1]河北中石油中心医院影像科,河北廊坊065000

出　　处：《河北医科大学学报》2024年第1期35-39,共5页Journal of Hebei Medical University

基　　金：廊坊市科学技术研究与发展计划(2022013021)。

摘　　要：目的 探讨多层螺旋CT(multi-slice spiral CT,MSCT)联合磁共振成像(magnetic resonance imaging,MRI)在肩关节损伤诊断及损伤程度判定方面的价值。方法 选取疑似肩关节损伤患者120例,分析MSCT、MRI检查诊断肩关节损伤的价值。结果 经关节镜检查确诊肩关节损伤89例;MSCT联合MRI诊断肩关节损伤的敏感度、准确度和阴性预测值分别为89.89%、88.33%和74.29%,明显高于MSCT和MRI单独诊断(P<0.05)。MSCT联合MRI判断损伤程度与关节镜检查结果一致性较高(Kappa值=0.864,P<0.05),MSCT联合MRI判断损伤程度准确率为93.75%。肩关节损伤患者头顶肩峰距MRI测量值明显低于非肩关节损伤患者,肩锁关节成角、肩峰角MSCT和MRI测量明显低于非肩关节损伤(P<0.05)。患侧MRI测量头顶肩峰距明显低于健侧,低于MSCT测量值(P<0.05)。患侧MRI测量肩峰喙突距明显高于健侧(P<0.05)。患侧MSCT和MRI测量肩锁关节成角明显低于健侧,肩峰角明显高于健侧(P<0.05)。结论 MSCT联合MRI在肩关节损伤诊断及损伤程度判断中有较好的应用价值,值得临床推广应用。Objective To explore the value of multi-slice spiral CT(MSCT) combined with magnetic resonance imaging(MRI) in the diagnosis and severity determination of shoulder joint injury.Methods A total of 120 patients with suspected shoulder joint injury were selected to analyze the value of MSCT and MRI in diagnosing shoulder joint injury.Results Eighty-nine patients with shoulder joint injury were diagnosed through arthroscopy.The sensitivity,accuracy,and negative predictive values of MSCT combined with MRI in the diagnosis of shoulder joint injury were 89.89%,88.33%,and 74.29%,respectively,which were significantly higher than those of MSCT and MRI alone(P<0.05).The consistency between MSCT combined with MRI in determining the severity of injury and arthroscopic examination results was high(Kappa value=0.864,P<0.05),and the accuracy of MSCT combined with MRI in determining the severity of injury was 93.75%.Patients with shoulder joint injury had significantly shorter head to shoulder distance and smaller angle of the acromioclavicular joint and acromial angle measured by MRI compared to patients without shoulder joint injury(P<0.05).The head to shoulder distance measured by MRI on the affected side was significantly shorter than that on the healthy side and that measured by MSCT(P<0.05).The distance between the acromial and coronoid processes measured by MRI on the affected side was significantly greater than that on the healthy side(P<0.05).The angle of the acromioclavicular joint measured by MSCT and MRI on the affected side was significantly smaller than that on the healthy side,and the acromial angle was significantly greater than that on the healthy side(P<0.05).Conclusion The combination of MSCT and MRI has good application value in the diagnosis and determination of shoulder joint injuries,and is worthy of clinical promotion and application.

关 键 词：肩损伤 多探头的计算机断层扫描 磁共振成像 

分 类 号：R684.73[医药卫生—骨科学]