不同超声征象在肩袖撕裂诊断中的效能研究

目的 探讨不同超声征象诊断肩袖撕裂的效能,筛选出诊断肩袖撕裂的特异性超声征象。方法 对133例肩关节超声征象进行分析,运用Logistic回归及诊断试验评估不同超声特征对肩袖撕裂的诊断效能。结果 单因素分析显示腱内异常回声、肩袖缺损、肌腱变薄、肩峰撞击综合征、肩峰下滑膜囊增厚、肱骨头骨质不整与肩袖撕裂显著相关。多因素分析显示腱内异常回声是肩袖撕裂的独立风险因素(P＜0.05,OR=2.85)。将腱内异常回声和肩袖缺损作为诊断肩袖撕裂的主要超声表现,与其他超声征象联合可以明显提高灵敏度和特异度。结论 腱内异常回声和肩袖缺损在RCT的超声诊断中,具有较高的灵敏度和特异度,与其他超声特征联合,可提高肩袖撕裂的诊断准确性。

Effectiveness of ultrasonographic features in diagnosis of rotator cuff tear

ABSTRACT Objective To explore the effectiveness of ultrasonographic features in the diagnosis of rotator cuff tear (RCT), and to screen the more specific signs for the diagnosis of rotator cuff tear. Methods The ultrasonographic parameters of 133 patients of RCT were analyzed by Logistic regression and diagnostic test, and to assess the diagnostic efficiency of different ultrasonographic features. Results Univariate analysis showed that intra-tendinous abnormal echo, disappearance of rotator cuff structure, tendon thinning, acromion impingement syndrome, subacromial synovial sac thickening and humeral head irregularity were significantly correlated with RCT. Finally, intra-tendinous abnormal echo was an independent risk factor for RCT (P<0.05, OR=2.85) through multivariate analysis. The intra-tendinous abnormal echo and the disappearance of rotator cuff structure are the main ultrasonographic criteria in the diagnosis of RCT. Combined with other parameters, the sensitivity and specificity can be significantly improved. Conclusion The intratendinous abnormal echo and rotator cuff defect have high sensitivity and specificity in the diagnosis of RCT, which can improve the diagnostic accuracy of rotator cuff tear by combining with other ultrasonographic features.