Magee Thomas, Williams David
Department of Radiology, Neuroskeletal Imaging, 255 N Sykes Creek Pkwy., Merritt Island, FL 32953, USA.
AJR Am J Roentgenol. 2006 Oct;187(4):881-6. doi: 10.2214/AJR.05.1047.
MRI of the shoulder has been found to be highly sensitive and specific for detection of full-thickness supraspinatus tendon tears at 1.5-T or lower field strength compared with arthroscopy. MRI of the shoulder at 3.0 T has not been specifically assessed. This study assesses the sensitivity and specificity of MRI at 3.0 T for supraspinatus tendon tears compared with arthroscopy.
Two experienced musculoskeletal radiologists retrospectively reviewed MR images of the shoulder in 150 consecutive patients who had subsequent arthroscopy. All patients had oblique coronal and sagittal T1-weighted and fat-saturated T2-weighted axial, oblique coronal, and sagittal imaging performed. The radiologists interpreted the MR images by consensus without knowledge of the arthroscopy results. Scans were interpreted for full-thickness or partial-thickness supraspinatus tendon tears. If partial-thickness supraspinatus tendon tears were seen on MRI, the reviewers noted whether the partial-thickness tear was articular or bursal in location. The radiologists also separated the supraspinatus tendon tears into small (< 1 cm retraction from the humeral head) and large (> 1 cm retraction from the humeral head). All 150 patients went on to arthroscopy. After consensus review of the MR images, arthroscopy results were compared with consensus MR interpretations.
Ninety-eight of the 150 patients had full-thickness supraspinatus tendon tears at arthroscopy. Twenty-six of the 150 patients had partial-thickness supraspinatus tendon tears. Seventeen of these 26 partial-thickness tears were along the articular surface and nine were along the bursal surface. Ninety-six of 98 full-thickness tears seen at arthroscopy were seen on consensus MRI interpretation. All 26 partial-thickness tears seen at arthroscopy were seen at consensus MR interpretation; however, two of the partial-thickness articular surface tears seen at arthroscopy were interpreted as full-thickness tears on consensus MRI interpretation. Twenty-eight of the 98 full-thickness supraspinatus tendon tears were small tears (< 1 cm retraction from the humeral head) on arthroscopy. Two of these 28 small tears seen on arthroscopy were not seen on consensus MRI interpretation. Twenty-six patients had intact supraspinatus tendons on both retrospective consensus MRI interpretation and at arthroscopy.
MRI of the shoulder at 3.0 T is highly sensitive and specific compared with arthroscopy in the detection of full-thickness and partial-thickness supraspinatus tendon tears.
与关节镜检查相比，已发现肩部MRI在1.5-T或更低场强下对检测冈上肌腱全层撕裂具有高度敏感性和特异性。尚未对3.0 T肩部MRI进行专门评估。本研究评估了3.0 T MRI与关节镜检查相比对冈上肌腱撕裂的敏感性和特异性。
两位经验丰富的肌肉骨骼放射科医生回顾性分析了150例连续接受关节镜检查患者的肩部MR图像。所有患者均进行了斜冠状位和矢状位T1加权以及脂肪抑制T2加权的轴位、斜冠状位和矢状位成像。放射科医生在不知道关节镜检查结果的情况下通过共识解读MR图像。扫描结果解读为冈上肌腱全层或部分层撕裂。如果在MRI上看到冈上肌腱部分层撕裂，审阅者会记录部分层撕裂是位于关节面还是滑囊面。放射科医生还将冈上肌腱撕裂分为小撕裂（距肱骨头回缩<1 cm）和大撕裂（距肱骨头回缩>1 cm）。所有150例患者均接受了关节镜检查。在对MR图像进行共识性审阅后，将关节镜检查结果与MR图像的共识性解读进行比较。
150例患者中有98例在关节镜检查时存在冈上肌腱全层撕裂。150例患者中有26例存在冈上肌腱部分层撕裂。这26例部分层撕裂中有17例位于关节面，9例位于滑囊面。关节镜检查时发现的98例全层撕裂中有96例在MRI共识解读中被发现。关节镜检查时发现的所有26例部分层撕裂在MR共识解读中均被发现；然而，关节镜检查时发现的2例部分层关节面撕裂在MRI共识解读中被解读为全层撕裂。关节镜检查时98例冈上肌腱全层撕裂中有28例为小撕裂（距肱骨头回缩<1 cm）。关节镜检查时发现的这28例小撕裂中有2例在MRI共识解读中未被发现。26例患者在回顾性MRI共识解读和关节镜检查时冈上肌腱均完整。
与关节镜检查相比，3.0 T肩部MRI在检测冈上肌腱全层和部分层撕裂方面具有高度敏感性和特异性。
