外伤性肩袖损伤MR平扫与MR关节造影的诊断价值

Shoulder MR imaging versus MR arthrography for traumatic rotator cuff tears

目的 :评价MR平扫和MR关节造影在外伤性肩袖损伤中的诊断价值。材料与方法 :经关节镜证实的外伤性肩袖撕裂25例 ,其中左肩10例 ,右肩15例 ,男性19例 ,女性6例 ;行常规的MR平扫后 ,在透视下穿刺肩关节腔注入15～20ml的混合性造影剂 ,在45分钟内完成再一次的MR扫描。结果 :关节镜证实肩袖的完全撕裂、部分撕裂分别为10例和15例。在肩袖完全撕裂中 ,MR平扫和MRA诊断的准确率分别为80 %(8 /10)和100 %(10 /10)。在肩袖部分撕裂中 ,MR平扫和MRA诊断的准确率分别为40 %(6/15)和66 7 %(10/15)。结论 :MR平扫和MR关节造影在外伤性肩袖损伤的诊断上均具有很高的准确率 ,但MRA要高于MR平扫 ,尤其在肩袖部分撕裂的诊断。

Objective:To evaluate the diagnostic value of MR imaging(MRI) and MR arthrography (MRA)in traumatic rotator cuff tears.Methods:It was included 25 cases of traumatic rotator cuff tears which were confirmed by arthroscopy.There were 10 left and 15 right shoulders,19 men and 6 women.After routine MRI,under fluoroscopic guidance,the glenohumerue joints were punctured and injected with 15-20ml of mixed contrast,and then the MR imaging was performed again within 45 minutes.Results:10 cases of complete tear and 15 cases of partial tear were confirmed by arthroscopy.In the complete tears,the diagnostic accuracy of MRI and MRA were 80%(8/10)and 100%(10/10)respectively.In the partial tears,the diagnostic accuracy of MRI and MRA were 40%(6/15),and 66 7%(10/15) respectively.Conclusions:Both MRI and MRA had the high accuracy for the diagnosis of traumatic rotator cuff injuries,but MRA was more accurate than MRI,especially in the diagnosis of the partial tears.