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肩袖损伤MR I与关节镜下表现对比的初步研究 预览 被引量:9

The preliminary comparative study between MRI and arthroscopy manifestation for rotator cuff injury
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摘要 目的:通过比较肩关节术前 MRI检查与关节镜下肩袖所见的异同,了解 MRI 对肩袖损伤诊断的准确性,并进一步明确肩袖损伤关节镜治疗的适应证。方法回顾性分析2007年7月至2010年12月北京大学人民医院创伤骨科行关节镜检查或治疗患者的59例肩部疾病患者,将MRI表现与关节镜所见进行对照分析。结果59例患者中,术前 MRI 检查明确诊断肩袖损伤36例,经关节镜证实肩袖撕裂35例,肩袖组织关节镜下结果完整,未见明显撕裂者1例;术前 MRI 检查未发现肩袖撕裂而关节镜下见撕裂7例,MRI检查与关节镜均未见肩袖撕裂者16例。MRI 对肩袖损伤诊断的敏感度为88.3%,特异度为94.1%,阳性预测值97.2%,阴性预测值69.6%。结论 MRI 是诊断肩袖损伤的有效辅助检查,但仍存在一定程度的漏诊,关节镜检查是诊断肩袖损伤最为可靠的辅助检查手段。 Objective Rotator cuff, a sleeve-like structure composed of supraspinatus, infraspinatus muscle,teres minor and subscapularis,is the major anatomical structure to maintain shoulder stability.Rotator cuff pathologies are frequently encountered in patients with pain at the shoulder.The rotator cuff can be visualized with different imaging techniques such as ultrasonography (US),arthrography,arthroscopy,computed tomography (CT)and magnetic resonance imaging (MRI).MRI had quickly become the favored method for preoperative diagnosis of the rotator cuff inj ury,with high soft tissue resolution ratio,sensitivity and accuracy.It is clinically significant to correctly understand the MRI manifestation of patients with the painful shoulder.We retrospectively analyzed the MRI examination and arthroscopy findings of 5 9 rotator cuff inj uries treated in one hospital.Methods (1)Subjects:From July 2007 to December 2010,a total of 59 patients (25 males and 34 females,aged from 24 to 83 years old,mean age 54.33 years),who underwent arthroscopic surgery for their shoulder joint diseases,were selected.All the patients had shouder MRI examination before operation,we compared their preoperative MRI results with surgical findings.(2)Arthroscopic surgery:All arthroscopic surgical procedures were performed by experienced directors or deputy directors of physicians to obtain an accurate diagnosis of the rotator cuff inj ury.All patients were treated by Stryker (Stryker)arthroscopic systems for their diagnosis and treatment.Diagnosis was based on the surgical records or video records.(3 )Magnetic resonance imaging:Multi-planar MR imaging of the shoulder was performed using coronal oblique,sagittal oblique and axial sequences.All MRIs were reported by a radiologist with special trained in musculoskeletal imaging.(4)Diagnosis of rotator cuff inj ury:Based on the lannotti classification criterion, according to their pathological changes,rotator cuff inj uries can be classified as ① Tendinitis:increased tendon signal intensity,no morph
作者 刘佳超 陈建海 黄伟 王天兵 姜保国 LIUJia-chao[1] CHEN Jian-hai[2] HUANGWei[2] WANG Tian-bing[2] JIANGBao-guo[2]
出处 《中华肩肘外科电子杂志》 2013年第1期共4页 CHINESE JOURNAL OF SHOULDER AND ELBOW (Electronic Edition)
关键词 肩关节 肩袖 关节镜 Shoulder Rotator cuff Arthroscopy
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