磁共振成像在肩袖损伤诊断中的应用——附100例临床结论分析

目的 通过对100例肩关节检查结果分析,讨论磁共振成像(MRI)对肩袖损伤诊断的作用.方法 回顾性研究2006年12月至2007年4月100例疑似肩袖损伤病人理学检查结果和MRI检查结论,并结合20例小切口开放肩袖修补术所见,比较两者对肩袖损伤诊断的作用.结果 对100例疑似肩袖损伤、Constant评分＜70分的病人行常规MRI检查,77例提示肩袖损伤(肌腱炎或肌腱断裂),7例肱二头肌长头腱损伤,8例肩锁关节炎,8例无明显影像学异常,临床诊断为"凝肩" .对20例肩袖损伤进行手术治疗,以术中所见分析术前不同理学检查和MRI检查对诊断肩袖损伤的作用.所有体检方式诊断肩袖断裂与否的特异性差,P＞0.05;MRI诊断肩袖断裂的特异性好,P＜0.05.结论 常规MRI检查对肩袖损伤的诊断具有重要作用,理学检查诊断肩袖损伤的灵敏度高,特异性差.理学检查结合MRI检查可提高肩袖损伤诊断的准确性,为临床制定治疗方案提供参考.

The role of Magnetic resonance imaging in the diagnosis of rotator cuff tears: analysis of 100 cases

Objective To evaluate the role of Magnetic resonance imaging(MRI)plays in the diagnosis of the rotator cuff lesions through 100 cases.Methods From December 2006 to April 2007,100 shoulders had been taken MRI exam.Among them, 20 shoulders had been received mini-open acromionplasty and rotator cuff repairs.Taking the results of the operation as reference to analyze specificity and sensitivity of MRI and physical exam in the diagnosis of rotator cuff injury.Results Of the 100 shoulders MRI,77 shoulders shows rotator cuff injury,8 shoulders were normal,7 shoulders were simple long bicep tenodesis or rupture while 8 shoulders show A-C joint degenerative disease.Twenty shoulders had been underwent operation.Using the results of operationas a reference to analysis the role that MRI and physical exam play in the diagnosis of rotator cuff injury.We find the physical exam has high sensitivity but low specificity in the diagnosis.No signal physical exam method has definitely affirmation in the diagnosis of rotator cuff lesion while the MRI has high specificity and sensitivity.Conclusions The MRI plays an important role in the diagnosis of rotator cuff tears.The physical exam has its deficiency in low specificity.Combined specific exam with MRI exam to improve the accuracy rate is the way to work in the future.