MRI及三维超声对肩袖损伤诊断方法的比较

摘要

Objective To evaluate the superiority of magnetic resonance imaging (MRI) and three-dimensional (3D) ultrasound in diagnosing rotator cuff tears (RCT) by comparing with the shoulder arthroscopy. Methods From August 2012 to January 2014, 46 patients with RCT used MRI and 3D ultrasound exam before operation, compared all result with each presentation of shoulder arthroscopy, in order to evaluate the accuracy of MRI and 3D ultrasound in diagnosing RCT. Results Among 46 patients, the diagnosis was 40 with full thickness RCT and 6 with partial thickness RCT by MRI; 37 patients with full thickness RCT and 9 patients with partial thickness RCT by 3D ultrasound; 39 patients with full thickness RCT and 7 patients with partial thickness RCT by shoulder arthroscopy. The sensibility, specificity and accuracy of MRI in diagnosing full thickness RCT was 97.4%, 71.4% and 93.4%;the sensibility, specificity and accuracy of 3D ultrasound was 92.3%, 85.7% and 91.3%. There was no significant difference between MRI and 3D ultrasound in diagnosing full thicknes RCT (P<0.05), but the specificity of MRI in diagnosing partial thickness RCT was better than 3D ultrasound (P <0.05). Conclusion Both 3D ultrasound and MRI has relatively high accuracy and specificity in diagnosing full thickness RCT, but MRI is better than 3D ultrasound in diagnosing partial thickness RCT.%目的：通过与术中肩关节镜下表现对比，探讨MRI 与三维超声对肩袖损伤(rotator cuff tears, RCT)诊断的优越性。方法2012年8月—2014年1月对46例肩袖损伤患者术前进行MRI及三维超声检查，并与其术中关节镜下表现进行对比分析，评价MRI及三维超声对肩袖损伤诊断的准确性。结果46例患者中，术前MRI检查诊断全层撕裂40例，部分撕裂6例；三维超声诊断全层撕裂37例，部分撕裂9例；术中关节镜诊断肩袖全层撕裂39例，部分撕裂7例。MRI检查对于诊断肩袖全层撕裂的敏感性是97.4%，特异性是71.4%，准确率为93.4%；三维超声对于诊断肩袖全层撕裂的敏感性是92.3%，特异性是85.7%，准确率为91.3%。三维超声与MRI检查对于冈上肌腱全层撕裂诊断的差异无显著性意义（P<0.05），但对部分撕裂诊断MRI检查特异性优于三维超声（P>0.05）。结论三维超声成像技术及MRI检查对肩袖全层撕裂的诊断均具有较高的准确率和敏感性，但对肩袖部分撕裂，MRI成像技术诊断价值优于三维超声检查。