特殊物理检查与MRI对冈上肌撕裂诊断价值的对比研究

Diagnostic value comparisons of special physical examinations and MRI for the supraspinatus tendon tear

目的比较特殊物理检查与MRI对诊断冈上肌撕裂的灵敏度、特异度及准确率等指标。方法对76例因肩关节疾患住院的病人,术前均进行特殊物理检查及MRI检查,然后行肩关节镜手术明确诊断并治疗,统计分析特殊物理检查和MRI对冈上肌撕裂诊断的灵敏度、特异度及准确率等,并进行比较。结果 76例患者经肩关节镜检查诊断为肩袖撕裂64例,其中冈上肌撕裂50例。Jobe征诊断冈上肌撕裂的灵敏度为82.00%,特异度为46.15%,准确率为69.74%;MRI诊断冈上肌撕裂的灵敏度为88.00%,特异度为38.46%,准确率为71.05%。Jobe征与MRI联合诊断对冈上肌撕裂的灵敏度为100%,特异度为30.77%,诊断准确率76.32%。结论 Jobe征等特殊物理检查与MRI的诊断价值相近,两者联合诊断可在临床上可以用来排除冈上肌撕裂的诊断。

Objective To compare the sensitivity, specificity and accuracy of special physical examinations and MRI for diagnosing the supraspinatus tendon tear. Methods A total of 76 patients with shoulder disorders who were all performed with a series of special physical examinations and MRI pre-operation were included. The arthroscopic surgery was used as the definite diagnostic method and therapeutic approaches. The sensitivity, specificity and accuracy of special physical ex-aminations and MRI for diagnosing the supraspinatus tendon tear were calculated and compared. Results Of the 76 pa-tients, 64 cases were diagnosed with rotator cuff tear after arthroscopy including 50 supraspinatus tendon tears. The sensi-tivity, specificity and accuracy of Jobe＇s test were 82.00%, 46.15% and 69.74% respectively. And the sensitivity, speci-ficity and accuracy of MRI were 88.00%, 38.46% and 71.05% respectively. The sensitivity of the Jobe＇s test combined with MRI was up to 100%, the specificity was 30.77%, and the accuracy was 76.32%. Conclusion Special physical ex-aminations such as Jobe＇s test have similar diagnostic value with MRI. The Jobe＇s test combined with MRI can exclude di-agnosis of supraspinatus tendon tear clinically.