高频超声与MRI诊断肩袖撕裂

目的 对比高频超声与MRI诊断创伤性与非创伤性肩袖撕裂(RCT)的效能。方法 纳入59例接受关节镜手术的创伤性(创伤组，n=35)与非创伤性(非创伤组，n=24)肩部疼痛和/或功能障碍患者，以关节镜所见为金标准，比较高频超声与MRI术前诊断RCT的效能，以及高频超声诊断符合率的组间差异。结果 关节镜诊断RCT 42例(42/59,71.19%),包括创伤组25例、非创伤组17例，均存在冈上肌腱撕裂；其中26例冈上肌腱全层撕裂、16例部分撕裂。高频超声与MRI诊断冈上肌腱全层撕裂(92.31%vs. 96.15%)与部分撕裂(62.50%vs. 75.00%)的准确率差异均无统计学意义(P均>0.05);组内二者诊断RCT效能差异均无统计学意义(P均>0.05)。高频超声(85.71%vs. 54.17%)及MRI(91.43%vs. 62.50%)诊断创伤组RCT符合率均大于非创伤组(P均<0.01);2组组内高频超声、MRI诊断符合率差异均无统计学意义(P均>0.05)。结论 高频超声诊断RCT效能与MRI相当。

High frequency ultrasound and MRI for diagnosing rotator cuff tear

Objective To compare the efficiency of high frequency ultrasound and MRI for diagnosing traumatic and non-traumatic rotator cuff tear (RCT). Methods Totally 59 patients with shoulder pain and/or dysfunction who underwent arthroscopic surgery were enrolled and divided into traumatic group (n=35) or non-traumatic group (n=24). Taken results of arthroscopy as gold standards, the efficacy of high frequency ultrasound and MRI for preoperative diagnosis of RCT were compared, and the coincidence rate of high frequency ultrasound for diagnosis of RCT in traumatic group and non-traumatic group were compared. Results Among 59 patients, RCT was diagnosed with arthroscopy in 42 cases (42/59, 71.19%), including 25 cases in traumatic group and 17 cases in non-traumatic group, both presented with tears of the supraspinatus tendon; 26 with full layer tears and 16 with partial tears of the supraspinatus tendon. No significant difference of accuracy between high frequency ultrasound and MRI for diagnosing full-thickness tear (92.31% vs. 96.15%) and partial tear of the supraspinatus tendon (62.50% vs. 75.00%, both P>0.05), nor of the efficacy of high frequency ultrasound and MRI for diagnosing RCT tears within groups (both P>0.05). In traumatic group, the diagnostic coincidence rate of high frequency ultrasound (85.71% vs. 54.17%) and MRI (91.43% vs. 62.50%) were both higher than those in non-traumatic group (both P<0.01). There was no significant difference of diagnostic coincidence rate between high frequency ultrasound and MRI within groups (both P>0.05). Conclusion High frequency ultrasound had comparable efficiency of MRI for diagnosing RCT.