超声检查在冈上肌腱损伤诊断、治疗与随访中的应用价值

Clinical value of ultrasound in diagnosing,treating and follow-up of patients with supraspinatus tendon injury

目的探讨超声检查在冈上肌腱损伤的诊断、治疗与随访中的应用价值。方法对广元市第一人民医院2014年5月—2015年10月间临床体格检查疑似冈上肌腱损伤的52例患者进行超声及MRI检查,根据病情行保守或手术治疗,结果与MRI及关节镜手术对照,并在后续不同恢复阶段行超声连续随访,观察冈上肌腱变化情况,为临床下一步治疗提供依据。结果经超声诊断为冈上肌腱损伤37例,以MRI结果为参照,超声检查发现冈上肌腱损伤的灵敏度为85.0%,特异度为75.0%,阳性似然比为91.9%,阴性似然比为60.0%,符合率为82.7%。37例患者中18例行保守治疗,7例行超声引导下针刺冈上肌腱钙化物捣碎及抽吸治疗,12例行关节镜手术。结论超声诊断冈上肌腱病变,准确性较高,可实现双侧对比,实时获取患者动态信息,必要时可引导局部病灶的定位、穿刺等,且费用较低,便于治疗随访。

Objective To investigate the value of ultrasound in diagnosing,treating and follow-up of patients with supraspinatus tendon injury.Methods Between May 2014 and October 2015,ultrasound and MRI examinations were performed on 52 patients who were suspected to have supraspinatus tendon injury in the First People＇s Hospital of Guangyuan.According to the conditions of the disease,patients underwent conservative or surgical treatment.The treatment results were compared with MRI and arthroscopic surgery.And regular ultrasound follow-up was performed at different recovery stages to observe the changes of the supraspinatus tendon,in order to provide corresponding basis for further clinical treatment.Results Ultrasound results showed that 37 patients had supraspinatus tendon injury.Based on MRI results,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and coincidence rate of the ultrasound examination were 85.0%,75.0%,91.9%,60.0% and 82.7%,respectively.Of these 37 patients,18 underwent conservative treatment,7 underwent calcified mass mashing and aspiration treatment through needles under the guidance of ultrasonography,and 12 underwent arthroscopic surgery.Conclusions Ultrasonography is accurate in diagnosing supraspinatus tendon injury,which can achieve bilateral comparison and real-time dynamic information of the patients.When it is necessary,it can also guide localization and puncture of local lesions.Furthermore,it is inexpensive and easy for treatment and follow-up.