X线、CT和MR关节造影在外伤性肩袖撕裂中的诊断价值

The value of conventional radiolgraph,CT ,MR arthrography in diagnosis of traumatic rotator cuff tears of the shoulder

目的 分析X线、CT和MR单对比关节造影在外伤性肩袖撕裂中的诊断价值。方法经关节镜证实的外伤性肩袖撕裂 2 0例。在透视下穿刺肩关节腔 ,注入 15～ 2 0ml的混合性对比剂 (由10ml欧乃派克和 2 0ml3mmol/L的马根维显稀释液组成 ) ,在 45min内完成X线摄片、CT和MR扫描。结果 关节镜证实肩袖的完全撕裂、部分撕裂分别为 9例和 11例。完全撕裂的X线、CT和MR关节造影均正确诊断 9例 (9/ 9)。肩袖部分撕裂的X线关节造影正确诊断 3例 (3/ 11) ;CT关节造影正确诊断 2例 (2 / 11) ;MR关节造影正确诊断 7例 (7/ 11)。

Objective To evaluate the conventional arthrography(CA), CT arthrography(CTA),and MR arthrography (MRA) in diagnosis of traumatic rotator cuff tears of the shoulder. Methods Twenty patients with traumatic rotator cuff tears confirmed by arthroscopy were retrospectively reviewed in this study. Glenohumeral joints were punctured percutaneously under fluoroscopic guidance, and 15-20 ml of mixed contrast were injected [10 ml of iodinated contrast (Omnipaque) mixed with 20 ml of 3 mmol/L gadopentetate dimeglumine solution(3 ml of 0.5 mol/L Magnevist in 500 ml of normal saline)],and then CA, CTA and MRA was taken within 45 minutes. Result 100% (9/9) of diagnostic accuracy was obtained in any of conventional, CT or MR shoulder arthrography in the state of complete tears. However, the accuracy of CA,CTA or MRA was 27.3% (3/11), 18.2% (2/11), 66.7% (7/11)respectively in the state of partial tears. Conclusion MRA is more effective to demonstrate the rotator cuff tears compared to CA or CTA.