实时超声检查与磁共振成像诊断冈上肌腱撕裂的对比研究

A comparison study between real-time ultrasonography and MRI for the diagnosis of supraspinatus tendon tear

目的评价实时超声检查与磁共振成像(MRI)对冈上肌腱撕裂病变的诊断价值。方法回顾性分析2003年1月至2008年1月间经手术证实冈上肌腱撕裂且临床资料完整的70例患者的实时超声检查及MRI检查资料,以开放手术或肩关节镜术中结果作为金标准,比较两种检查方法的有效性。结果 70例冈上肌腱撕裂,术前实时超声检查诊断65例,MRI诊断67例。实时超声检查诊断冈上肌腱撕裂的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为92.8%、82.1%、92.8%、82.1%及89.8%。MRI诊断冈上肌腱撕裂的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.7%、85.7%、94.4%、88.9%及92.9%。经χ2检验,冈上肌腱撕裂实时超声检查的有效性与MRI检查的有效性无统计学差异(χ2=0.09,P>0.05)。结论实时超声检查与MRI同样能够准确地诊断冈上肌腱撕裂,可作为冈上肌腱检查的首选影像学方法 。

Objective To compare real-time ultrasonography with MRI in diagnosis of supraspinatus tendon tears. Methods Seventy patients with supraspinatus tendon tear confirmed by arthroscopic surgery from Jan 2003 to Jan 2008 were included in the study. Based on arthroseopic surgery findings, records of ultrasonography and MRI were analysed. Results In 70 supraspinatus tendon tears, 65 were confirmed by uhrasonography and 67 were found by MRI. For detecting supraspinatus tendon tear, the sensitivity, speci- ficity, positive prospective value, negative prospective value and accuracy were 92.8% , 82.1% , 92.8% , 82.1% and 89.8% for uhrasonography while 95.7% , 85.7% , 94.4% , 88.9% and 92.9%for MRI, respectively. There was no difference between ultrasonography and MRI for diagnosis of supraspinatus tendon tear （ X2 = 0.09, P 〉 0.05 ）. Conclusion The real-time ultrasonography can evaluate supraspinatus tendon tear effectively as MRI and can be a first-choice diagnosing imaging method.