肩袖损伤的物理诊断和影像诊断与关节镜对照研究

【作者】 梁永辉；

【导师】 朱挺敏；

【作者基本信息】 延边大学 ， 影像医学与核医学， 2007， 硕士

【摘要】 目的：分析研究肩袖损伤的症状及影像学表现，并与关节镜诊断结果相对照，评价物理检查对肩袖损伤诊断的准确性和临床应用价值以及对比分析常规MR、肩关节造影、MR肩关节造影对肩袖撕裂的价值。材料和方法：本研究包括18例肩袖全层撕裂、11例部分撕裂和30例无肩袖撕裂病例。第一部分，重点探讨了肩袖撕裂的物理检查对肩袖撕裂的诊断价值；第二部分，重点比较了常规MR、肩关节造影、MR肩关节造影三种方法诊断肩袖撕裂的价值和优缺点。结果：35例患者经肩关节镜检查诊断为：肩袖全层撕裂18例、肩袖部分撕裂11例、肩袖无撕裂6例。物理检查诊断准确率为83％。影像学检查对于判定有无肩袖撕裂，常规MRI的敏感性、特异性和准确性分别为78％，80％，81％；肩关节腔造影分别为94％，93％，93％；MRA为100％，95％，97％。对于判定有无肩袖全层撕裂，常规MRA的敏感性、特异性和准确性分别为83％，86％，81％；肩关节腔造影分别为91％，93％，86％；MRA为100％，100％，100％。结论：物理检查是诊断肩袖损伤准确性相当可靠，在三种影像诊断方法中，常规MR是诊断肩袖撕裂，比较准确的方法，肩关节造影的诊断准确性要高于常规MR，MRA则是最准确的方法结论MRA是诊断肩袖撕裂准确性较高的方法更多还原

【Abstract】 Objective: To evaluate the value of physical examination and imaging in the diagnosis of rotator cuff tears. Perspective study was also performed to compare the diagnostic value of different methods including routine MR, arthrograp, and MRAMaterials and Methods: Seventy consecutive patients with suspected rotator cuff tears were examined with physical examination, X-ray arthrography ,routine MR, arthrography, and MR arthrography before the of the examination of .shoudler arthroscope. Base on the results of the arthrography, the diagnostic sensitivity, specificity, and accuracy of the physical examination, and the diagnostic value of routine MR, arthrography, and MR arthrography were compared. The advantages and disadvantages of every method were also discussed.Results: The 35 cases included 18 full-thickness tears, 11 Partial thickness tears and 6 non-tears. Based on the shoudler arthroscope accuracy of physical examination were83%. For the diagnosis rotator cuff tears the sensitivity, specificity, and accuracy were 78%, 80%, and 81% of the routine MR. respectively ;the figures were 94%,93%,and 93% of the X-ray arthrography. respectively ;while the date were 100%, 95%, and 97% for MRA. for the diagnosis full-thickness tears the sensitivity, specificity, and accuracy were 83%, 86%, and 81% of the routine MR ;respectively ;the figures were 91%, 93%, and 86% of the X-ray arthrography, respectively ;while the date were 100%, 100%, and 100% for MRAConclusion: physical examination is a good modality in the diagnosis of rotator cuff tears. The routine MR is a relatively accurate method for revealing rotator cuff tears. The accuracy of arthrography for rotator cuf tears is higher than that of routine MR. MRA is the most accurate method among these three diagnostic imaging methods.更多还原