摘要
Abstract
Objective To investigate the abilities of MRI, MR shoulder joint arthrography (MRAr) and high fre-quency ultrasound in diagnosis of rotator cuff injury. Methods Eighty four patients with suspected rotator cuff injury were treated in The Fifth Central Hospital of Tianjin from February 2015 to September 2016, there were 52 males and 32 fe-males, aged 22-64 years, with an average of (48.2 ±12.1) years. Retrospectively analyzed the imaging data of MRI, MR shoulder joint arthrography and high frequency ultrasound,χ2 test was used to compare the difference in diagnostic efficacy between MRI and high frequency ultrasound. Kappa test was used to analyze the consistency of MRI, high frequency ultra-sound with shoulder arthroscopy, and the consistency of the 3 methods of MRI, high frequency ultrasound and MRAr com-bined with shoulder arthroscopy was analyzed respectively. Results The accuracy of MRI, MRAr, and high frequency ul-trasound in the diagnosis of typeⅠrotator cuff injury was 100%. MRAr has a very high detection rate for typeⅠ, type Ⅱ and type Ⅳ rotator cuff injury, and the accuracy was 97.8%(45/46), but was invalid for type Ⅲ, typeⅤand typeⅥrota-tor cuff injury. The sensitivity, specificity and accuracy of MRI and high frequency ultrasound in the diagnosis of rotator cuff injury were:88.8%, 75.0%, and 88.1%;87.5%, 75%, and 86.9%, respectively, and there were not statistically signif-icant between them (χ2=0.856, P=0.1). Combining MRI, MRAr and high frequency ultrasound, the sensitivity, specificity and accuracy in diagnosing rotator cuff injury were 93.7%, 100%and 94%, respectively. The three methods had good con-sistency compared with shoulder arthroscopy in detecting rotator cuff injury (κ=0.81, P=0.001;κ=0.79, P<0.001;κ=0.94, P<0.001, respectively). Conclusion High frequency ultrasound can be used as the primary method for rotator cuff injury, and MRI is an effective complement. MRAr has a very high detection rate for type Ⅰ,Ⅱ type, and type Ⅳ rotator cuff in-jury. The three methods complement each other, and combination can improve the diagnostic accuracy.关键词
肩袖损伤/磁共振成像/肩关节造影/高频超声/肩关节镜/对比剂Key words
Rotator cuff injury/Magnetic resonance imaging/Shoulder joint arthrography/High frequency ultrasound/Shoulder arthroscopy/Contrast agent分类
医药卫生
