摘要
目的探讨MRA检查对肩袖损伤的诊断价值。方法回顾性分析127例肩袖损伤MRA及MRI表现,与肩关节镜手术结果对照。结果 127例肩袖损伤病例,MRI诊断肩袖完全撕裂的敏感度、特异度及准确度分别是79.25%、82.43%和81.10%;诊断部分撕裂的敏感度、特异度及准确度分别是73.33%、67.31%和70.87%;其一致性较好(Kappa=0.708),差异均有统计学意义(P<0.05)。MRA诊断Ⅰ型8例(6.30%)、Ⅱ型21例(16.54%)、Ⅳ型32例(25.20%),其敏感度分别为100%、95.24%、96.88%;特异度分别为100%、99.06%、98.95%;准确度分别为100%、98.43%、98.43%;明显高于常规MRI诊断;与关节镜结果对比,其一致性极佳(Kappa=0.944),差异均有统计学意义(P<0.05);而对于Ⅲ型、Ⅴ型和Ⅵ型肩袖损伤,MRA均不能显示其损伤部位及程度,无法对其进行诊断。结论 MRA能准确判断Ⅰ型、Ⅱ型和Ⅳ型肩袖撕裂范围及程度,是MRI诊断肩袖损伤的有效补充,为临床诊断和治疗能提供更准确的依据。
Objective To investigate the value of MR arthrography (MRA) in diagnosis of rotator cuff injury. Methods We retrospectively analysed MRA and MRI performance of 127 cases with rotator cuff injury, and contrasted it with the results of ar- throscopy. Results For all 127 cases, the sensitivity, which were diagnosed as complete rotator cuff injury by MRI, was 79.25% , the specificity was 82.43% , and the accuracy was 81.10% ; the sensitivity, which were diagnosed as partial rotator cuff inyunry, was 73.33% , the specificity was 67.31% , and the accuracy was 70.87% ; the diagnostic results was same to that by arthroscopy ( Kappa = 0. 708), and the difference had statistical significance ( p 〈 0.05). Used MRA to diagnose type I 8 cases (6.30%), type Ⅱ 21 cases (16.54%), type IV 32 cases (25.20%), and the sensitivity was respectively 100%, 95. 24% , 96.88% ; the specificity was respectively 100% , 99.06% , 98.95% ; the accuracy was respectively 100% , 98.43%, 98.43%. The diagnostic results which was obviously higher than comvertional MRI diagnostic was same to that by arthroscopy ( Kappa = 0. 944 ) , and the difference had statiatical sigmificance ( P 〈 0. 05 ). However, for type Ⅲ, Ⅴand Ⅵ rotator cuff in- jury, MRA weren' t able to diagnose and show the damage location and degree. Conclusion MRA, an effective complement of MRI in the diagnosis of rotator cuff injury, can accurately determine the scope and degree of type Ⅰ , Ⅱ and Ⅳ rotator cuff tear, and it can provide more aceuratebasis for clinical diagnosis and treatment.
出处
《医学影像学杂志》
2016年第9期1683-1687,共5页
Journal of Medical Imaging
关键词
磁共振成像
肩关节造影
肩袖
损伤
Magnetic resonance imaging (MR)
Shoulder arthrography
Rotator cuff
Injury