高频超声检查在肩袖撕裂诊断中的应用价值

Application value of high frequency ultrasound in the diagnosis of rotator cuff tears

目的探讨高频超声检查在肩袖撕裂诊断中的应用价值。方法采用前瞻性研究方法,选取2016年4月至2019年5月首都医科大学附属北京友谊医院收治的肩袖撕裂患者92例(106肩)。所有患者在肩关节镜手术前均接受肩关节磁共振检查和高频超声检查。将关节镜检查结果作为金标准,比较磁共振、高频超声检查诊断肩袖撕裂以及对肩袖撕裂口大小测量准确性的差异。计算磁共振检查和超声检查诊断肩袖撕裂的准确性、特异性和敏感性,比较两种检查方法的有效性和测量准确性。结果在肩袖撕裂检查中,与关节镜检查结果相比,磁共振检查的准确性为90.6%、敏感性为95.7%、特异性为52.1%,而高频超声检查的准确性为88.7%、敏感性为93.5%、特异性为53.8%,两种检查方法对肩袖撕裂的诊断效能差异无统计学意义(P>0.05)。在测量肩袖撕裂口准确性上,两种方法之间差异无统计学意义(P>0.05),但是两种检查方法和关节镜测量肩袖撕裂大小存在差异,且差异有统计学意义(P<0.05)。结论在肩袖撕裂诊断中,高频超声检查是一种诊断可靠、操作简单的诊断方法,对肩袖撕裂具有较高的诊断价值,有经验的超声科医师做出的诊断结合骨科医师查体能够较准确地诊断肩袖撕裂,但是不能准确地测量肩袖撕裂的大小。

Objective To investigate the application value of high frequency ultrasound in the diagnosis of rotator cuff tears.Methods Ninety-two patients(one hundred and six shoulders)diagnosed with rotator cuff tears were admitted in Beijing Friendship Hospital,Capital Medical University from April 2016 to May 2019 were enrolled in this prospective study.All the patients were underwent magnetic resonance imaging and high frequency ultrasound of shoulders before shoulder arthroscopy.The examination results of arthroscopy were considered as the gold standard for diagnosis,and the difference in the accuracy of diagnosis and measuring rotator cuff size between magnetic resonance imaging and high frequency ultrasound was compared.The accuracy,specificity and sensitivity of magnetic resonance imaging and high frequency ultrasound in diagnosis of rotator cuff tears were calculated.The efficacy of magnetic resonance imaging and high frequency ultrasound in diagnosis of rotator cuff tears and the accuracy of measuring rotator cuff size were analyzed.Results In the diagnosis of rotator cuff tears,the accuracy,specificity and sensitivity of magnetic resonance imaging were 90.6%,95.7%and 52.1%respectively,while those of high frequency ultrasound were 88.7%,93.5%and 53.8%respectively.The difference between magnetic resonance imaging and high frequency ultrasound in diagnosis of rotator cuff tears was not statistically significant(P>0.05).The difference between two diagnosis approaches in measuring rotator cuff tears size was not statistically significant(P>0.05).However,comparing the results of the two diagnosis approaches with arthroscopy in measuring rotator cuff tears size,the differences were statistically significant(P<0.05).Conclusion In the diagnosis of rotator cuff tears,high frequency ultrasound is a reliable approach with simple operation and has high application value.Combining the reports by a sufficiently-trained radiologist with physical examination can accurately diagnose rotator cuff tears,but cannot accurately measure the size of rotator cuff tears.