文章摘要
朱思政,杨建业,秦磊磊,王家炜,胡宁.超声:可替代MRI评估肩胛下肌腱撕裂?.骨科,2020,11(6):469-474
超声:可替代MRI评估肩胛下肌腱撕裂?
Ultrasound: can it replace MRI to evaluate subscapular tendon tears?
投稿时间:2020-08-31  
DOI:10.3969/j.issn.1674-8573.2020.06.002
中文关键词: 肩关节镜  肩胛下肌腱  磁共振  超声  诊断准确性
英文关键词: Shoulder arthroscopy  Subscapular tendon  Magnetic resonance imaging  Ultrasound  Diagnostic accuracy
基金项目:
作者单位E-mail
朱思政 重庆医科大学附属第一医院骨科重庆 400010  
杨建业 重庆医科大学附属第一医院骨科重庆 400010  
秦磊磊 重庆医科大学附属第一医院骨科重庆 400010  
王家炜 重庆医科大学附属第一医院骨科重庆 400010  
胡宁 重庆医科大学附属第一医院骨科重庆 400010 1276321387@qq.com 
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中文摘要:
      目的 探讨术前超声和MRI对肩胛下肌腱撕裂的诊断价值。方法 回顾性纳入2019年1月至2020年6月在我科初次行肩关节镜手术的111例,收集病人术前超声和MRI报告,与术中手术资料进行比较,分析超声与MRI诊断肩胛下肌腱撕裂的敏感性、特异性、准确性以及阳性预测值、阴性预测值。结果 本组33.3%(37/111)病人术中证实有肩胛下肌腱撕裂。超声诊断出19例肩胛下肌腱撕裂,敏感性:51.35%,特异性:100.00%,阳性预测值:100.00%,阴性预测值:80.43%;在83.78%的病例中,超声能够准确地识别肩胛下肌腱撕裂。MRI诊断出13例肩胛下肌腱撕裂,敏感性:35.14%,特异性:100.00%,阳性预测值:100.00%,阴性预测值:75.51%,准确性:78.38%。对于Ⅰ型肩胛下肌腱撕裂,超声诊断的敏感性:40.00%,特异性:100.00%,而MRI诊断的敏感性:13.33%,特异性:100.00%。结论 尽管有一定的局限,超声在预测肩胛下肌腱撕裂方面的效能明显优于MRI,是术前可供选择的一种有效检查。
英文摘要:
      Objective To explore the diagnostic value of preoperative ultrasound and MRI for subscapular tendon tear. Methods A total of 111 cases of primary shoulder arthroscopy in our department from January 2019 to June 2020 were retrospectively included. The preoperative ultrasound/MRI reports were collected, and compared with those during the operation. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasound/MRI in the diagnosis of subscapular tendon tear were analyzed. Results In this study group, a subscapular tendon tear was intraoperatively confirmed in 33.3%(37/111) of patients. In overall subscapular tendon tear, for ultrasound, there was a sensitivity of 51.35%, specificity of 100.00%, positive predictive value of 100.00%, negative predictive value of 80.43%. In 83.78% of cases, ultrasound could identify subscapular tendon tears accurately. MRI had an overall sensitivity of 35.14%, specificity of 100.00% and accuracy of 78.38%. The positive predictive value was 100.00%, and the negative predictive value was 75.51%. For type I subscapular tendon tear, the sensitivity and specificity for ultrasound and MRI was 40.00% and 100.00%, 13.33% and 100.00%, respectively. Conclusion Although there are some limitations, ultrasound is superior to MRI in predicting subscapular tendon tears, which is an effective preoperative examination.
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