Arslan G, Apaydin A, Kabaalioglu A, Sindel T, Lüleci E
Department of Radiology, Akdeniz University School of Medicine, Arapsuyu, Antalya, Turkey.
J Clin Ultrasound. 1999 Jul-Aug;27(6):335-9. doi: 10.1002/(sici)1097-0096(199907/08)27:6<335::aid-jcu4>3.0.co;2-0.
Our purpose was to determine the association between sonographically detected subacromial/subdeltoid (SA/SD) bursal and biceps tendon sheath effusions and arthrographically proven rotator cuff tears.
Shoulder sonography reports and sonograms of 105 shoulders in 102 patients who also underwent arthrography were retrospectively reviewed for the presence of fluid within the biceps tendon sheath and SA/SD bursa. Reports and sonograms for 151 asymptomatic shoulders were also reviewed.
Biceps tendon sheath effusion and/or bursal fluid were detected in 50 (48%) of 105 shoulders. Fifty-one patients had rotator cuff tears; 28 of them had effusions at 1 or both sites. The sensitivity, specificity, and positive predictive value (PPV) of biceps tendon sheath effusions for diagnosing rotator cuff tear were 35%, 74%, and 56%, respectively. For SA/SD bursal effusions, the sensitivity, specificity, and PPV were 8%, 94%, and 57%, respectively. For combined biceps tendon sheath and bursal effusions, the sensitivity, specificity, and PPV were 12%, 91%, and 54%, respectively. There was no statistically significant association between rotator cuff tears and effusions in the biceps tendon sheath, SA/SD bursa, or both. Among the 151 asymptomatic shoulders, 12 (7.9%) had biceps tendon sheath fluid, 5 (3.3%) had SA/SD bursal effusion, and 2 (1.3%) had both biceps tendon sheath and bursal effusions.
The sonographic detection of intraarticular fluid, SA/SD bursal fluid, or both has a low sensitivity and PPV in the diagnosis of rotator cuff tears. Isolated intra-articular and/or SA/SD bursal effusions are not reliable signs of rotator cuff tear.
我们的目的是确定超声检测到的肩峰下/三角肌下（SA/SD）滑囊和肱二头肌肌腱腱鞘积液与关节造影证实的肩袖撕裂之间的关联。
回顾性分析102例患者105个肩部的超声检查报告和超声图像，这些患者同时接受了关节造影，以检查肱二头肌肌腱腱鞘和SA/SD滑囊内是否存在积液。还回顾了151个无症状肩部的报告和超声图像。
105个肩部中有50个（48%）检测到肱二头肌肌腱腱鞘积液和/或滑囊积液。51例患者存在肩袖撕裂；其中28例在1个或2个部位有积液。肱二头肌肌腱腱鞘积液诊断肩袖撕裂的敏感性、特异性和阳性预测值（PPV）分别为35%、74%和56%。对于SA/SD滑囊积液，敏感性、特异性和PPV分别为8%、94%和57%。对于肱二头肌肌腱腱鞘和滑囊积液合并存在的情况，敏感性、特异性和PPV分别为12%、91%和54%。肩袖撕裂与肱二头肌肌腱腱鞘、SA/SD滑囊或两者的积液之间无统计学显著关联。在151个无症状肩部中，12个（7.9%）有肱二头肌肌腱腱鞘积液，5个（3.3%）有SA/SD滑囊积液，2个（1.3%）同时有肱二头肌肌腱腱鞘和滑囊积液。
超声检测关节内积液、SA/SD滑囊积液或两者在肩袖撕裂诊断中的敏感性和PPV较低。孤立的关节内和/或SA/SD滑囊积液不是肩袖撕裂的可靠征象。
