常规超声联合经皮超声引导下肩峰下滑囊造影对冈上肌腱撕裂的诊断价值

目的评估常规超声联合经皮超声引导下肩峰下滑囊造影(PUSB)对冈上肌腱撕裂的诊断价值方法疑似冈上肌腱撕裂患者100例,随机分成两组,各50例常规超声组行常规超声检查,常规超声联合PUSB组行常规超声联合PUSB检查。以关节镜检查作为金标准,比较两种方法在诊断岡上肌腱撕裂的敏感性、特异性及准确性结果对照组诊断闰上肌腱撕裂34例,16例疑似閃上肌腱撕裂。观察组诊断岡上肌腱撕裂43例,7例为疑似冈上肌腱撕裂肩关节镜检查:常规超声检查50例中,冈上肌腱撕裂41例,9例为正常的冈上肌腱常规超声联合PUSB检查50例中,诊断冈上肌腱撕裂44例,6例为正常的冈上肌腱,常规超声检查诊断冈上肌腱的敏感性为75.6%,特异性为66.6%,诊断准确率为74%。常规超声联合PUSB检查诊断冈上肌腱撕裂的敏感性为93.1%,特异性为66.6%,诊断准确率为90%。结论常规超声联合PUSB可动态观察造影剂进入冈上肌腱的弥散情况,对冈上肌腱撕裂的诊断具有较高应用价值。

Objective To evaluate the application value of conventional ultrasound combined with percutaneous ulrasound-guided subacromial bursography(PUSB)in the diagnosis of supraspinatus tendon tear.Methods A total of 100 suspected patients with supraspinatus tendon tear were randomly divided into two groups,one group of 50 underwent conventional ultrasound examination and the other group of 50 underwent conventional ultrasound combined with PUSB examination.Arthroscopy was perfomied as the gold standard of diagnosis.The sensitivity,specificity and accuracy of the two methods in the diagnosis of supraspinatus tendon tear were compared.Results Conventional ultrasound suspected supraspinatus tendon tears in 50 cases,diagnosis of supraspinatus tendon tears in 34 cases,16 cases were suspected with supraspinatus tendon tears.Conventional ultrasound combined with PUSB examined 50 cases of suspected supraspinatus tendon tear,of which 43 cases were diagnosed with supraspinatus tendon tear and 7 cases were suspected with supraspinatus tendon tear.Shoulderarthroscopy:in the 50 cases of conventional ultrasound,41 cases of supraspinatus tendon tear were diagnosed,9 cases were normal shoulder joints.Among the 50 cases examined by conventional ultrasound combined with PUSB,44 cases were diagnosed with supraspinatus tendon tear and 6 cases were normal shoulder joints.The sensitivity,specificity and diagnostic accuracy of conventional ultrasound in the diagnosis of supraspinatus tendon tear were 75.6%,66.6%and 74%respectively.The sensitivity,specificity and accuracy of conventional ultrasound combined with PUSB in the diagnosis of supraspinatus tendon tear were 93.1%,66.6%and 90%respectively.Conclusion Conventional ultrasound combined with PUSB can dynamically observe the shape,internal echo and movement direction of the supraspinatus tendon in real dine,and observe the dispersion of the contrast agent after entering the supraspinatus tendon,which has a high application value for the diagnosis of supraspinatus tendon tear.