X线与MRI在肩峰下撞击综合征诊断中的应用价值比较

Comparison of the application value of X-ray and MRI in the diagnosis of subacromial impingement syndrome

目的对比分析X线检查和MRI检查在肩峰下撞击综合征诊断中的应用价值。方法选取首都医科大学附属北京天坛医院2019年1月至2021年5月临床表现为肩部疼痛、无力的患者60例,所有患者均行X线和MRI检查,以临床诊断为金标准,对比分析X线检查和MRI检查在肩峰下撞击综合征中的诊断效能。结果MRI检查与金标准一致性较好(K_(appa)=0.769,P<0.01),X线检查与金标准一致性一般(K_(appa)=0.464,P<0.01);X线检查与MRI检查肩峰形态分型、肩峰下间隙比较差异无统计学意义(P>0.05);MRI检查灵敏度高于X线检查,差异有统计学意义(χ^(2)=4.00,P<0.05),MRI检查特异度与X线检查无差别,差异无统计学意义(χ^(2)=0.25,P>0.05)。结论X线与MRI检查诊断肩峰下撞击综合征,两者互为补充,临床首先进行X线检查,必要时再进行MRI检查。

Objective To compare and analyze the value of X-ray examination and MRI in the diagnosis of subacromial impingement syndrome.Methods Sixty patients with shoulder pain and weakness in Beijing Tiantan Hospital,Capital Medical University from January 2019 to May 2021 were selected.All patients underwent X-ray and MRI.Taking clinical diagnosis as the gold standard,the diagnostic efficacy of X-ray and MRI in subacromial impact syndrome was compared and analyzed.Results The consistency between MRI and gold standard was good(K_(appa)=0.769,P<0.01),and the consistency between X-ray and gold standard was general(Kappa=0.464,P<0.01);there was no significant difference between X-ray examination and MRI examination of acromion morphological classification,subacromial space classification(P>0.05);The sensitivity of MRI was higher than that of X-ray,and the difference was statistically significant(χ^(2)=4.00,P<0.05).There was no difference between MRI and X-ray,and the difference was not statistically significant(χ^(2)=0.25,P>0.05).Conclusions X-ray and MRI are complementary to each other in the diagnosis of subacromial impingement syndrome.X-ray examination should be carried out first,and MRI should be carried out when necessary.