肩袖损伤患者MRI和MR肩关节造影的诊断价值比较

目的比较肩袖损伤患者MRI和MR肩关节造影的诊断价值。方法以2013年7月-2014年12月前来我院就诊106例疑似肩袖损伤患者进行研究,均行MRI检查,随后有55例行肩关节MR造影检查,其中20例高度疑似病例再接受关节镜诊治确诊。比较MRI和MR的诊断准确性。结果 20例行关节镜检查患者确诊为12例肩袖部分撕裂、5例肩袖全层撕裂、3例肩袖变性,其中6例为肩袖撕裂并发盂唇损伤,MRI确诊准确性为55(11/20),明显低于MRar的100.0%(20/20),比较有统计学意义(χ2=11.613,P=0.0000.05)。结论虽然MRI与MRar均无法较好显示肩袖钙化情况,但MRar在肩袖损伤临床诊断中的应用具有更高准确性,可作为首先诊断方法。

Comparison of the Diagnostic Value of Shoulder Joint Arthrography with MRI and MR in Patients with Rotator Cuff Injury

Objective To compare the diagnostic value of shoulder joint arthrography with MRI and MR in patients with rotator cuff injury.Methods 106 cases of patients with suspected rotator cuff injury admitted into the hospital during July 2013 to December 2014 were studied and all of them received MRI examination. Then, there were 55 cases receiving arthrography with MR and 20 of whom were highly suspected cases and received arthroscopic diagnosis and treatment to make a definite diagnosis. The diagnostic accuracy of MRI and MR was compared.Results Among 20 cases of patients examined by arthroscopy, there were 12 cases diagnosed as having partial-thickness rotator cuff tears, 5 cases as full-thickness rotator cuff tears and 3 cases as rotator cuff degeneration, including 6 cases as rotator cuff tear concurrent glenoid labrum injury. The accuracy of MRI diagnosis was 55.0% (11/20) which was significantly lower than 100.0% (20/20) of Mrar and the comparison was statistically significant (χ2=11.613, P=0.000<0.05). Conclusion Although both of MRI and MRar can not well show the status of rotator cuff calcification, the application of MRar in the clinical diagnosis of rotator cuff injury is of higher accuracy, which can be used as the first diagnostic method.