军事训练中肩袖撕裂多模态影像诊断与应用价值评估

Multimodal Imaging Diagnosis and Application Value Evaluation of Rotator Cuff Tear in Military Training

目的分析比较高频超声(high-frequency ultrasound,HFUS)、超声造影(contrast-enhanced ultrasound,CEUS)以及磁共振成像(magnetic resonance imaging,MRI)在军事训练所致肩袖撕裂中的诊断效能。方法选取68例临床怀疑肩袖损伤的军事训练伤患者资料,以关节镜术中诊断为金标准,对HFUS、CEUS和MRI 3种检查手段对肩袖撕裂的诊断价值予以分析和比较。结果68例患者中,关节镜确诊肩袖撕裂62例,无肩袖撕裂伤6例。对于判断有无肩袖撕裂,HFUS的灵敏度、特异度和准确率分别为96.77%、50.00%和92.56%,CEUS的分别为95.16%、50.00%和91.18%,MRI的分别为98.39%、66.67%和95.59%,3种方法对诊断有无肩袖撕裂均有统计学意义(P<0.05),3种方法之间差异无统计学意义(P>0.05)。HFUS诊断肩袖撕裂程度的灵敏度、特异度和准确率分别为87.50%、94.44%和91.67%,CEUS的分别为88.46%、93.94%、91.53%,MRI的分别为91.67%、94.59%、93.44%,3种检查方法对诊断肩袖撕裂程度均有统计学意义(P<0.05),但3种检查方法之间的差异无统计学意义(P>0.05)。结论HFUS、CEUS和MRI对肩袖撕裂准确率的诊断准确率均较高,3种影像学方法可作为相互补充,其中HFUS因检查简单便捷可推广应用于军事训练所引起的肩袖损伤筛查中。

Objective To analyze and compare the diagnostic efficacy of high-frequency ultrasound(HFUS),contrast-enhanced ultrasound(CEUS)and magnetic resonance imaging(MRI)in rotator cuff tears caused by military training.Methods The data of 68 military training injured patients with suspected rotator cuff injury were selected,and the diagnostic value of HFUS,CEUS and MRI for rotator cuff tear were analyzed and compared by arthroscopic diagnosis based on the gold standard of arthroscopic diagnosis.Results In the 68 patients,62 were diagnosed as rotator cuff tears by arthroscopy and 6 without.The sensitivity,specificity and accuracy of HFUS were 96.77%,50.00%and 92.56%respectively,CEUS was 95.16%,50.00%and 91.18%,MRI was 98.39%,66.67%and 95.59%respectively,the three methods has statistical significance in the diagnosis of rotator cuff tear(P<0.05),but there was no significant difference among the three methods(P>0.05).The sensitivity,specificity and accuracy of HFUS in diagnosing rotator cuff tear were 87.50%,94.44%and 91.67%respectively,CEUS were 88.46%,93.94%and 91.53%respectively,and MRI were 91.67%,94.59%and 93.44%respectively.The three inspection methods were statistically significant in diagnosing rotator cuff tear(P<0.05),but there was no significant difference among the three inspection methods(P>0.05).Conclusion The accuracy of HFUS,CEUS and MRI in the diagnosis of rotator cuff tear is high.The three imaging methods can complement each other.Among them,HFUS can be widely used in the screening of rotator cuff injury caused by military training because of its simple and convenient examination.