Goldsmith S, Yang S S
Department of Orthopedic Surgery, Lenox Hill Hospital, New York, USA.
J Hand Surg Eur Vol. 2008 Oct;33(5):595-9. doi: 10.1177/1753193408092041.
Small occult dorsal wrist ganglia, which are not visible or palpable, may be painful. Clinically, there is tenderness over the scapholunate ligament and pain with hyperextension of the wrist with normal radiographs and an otherwise normal examination. We reviewed 20 patients with suspected occult ganglia who underwent an MRI scan and subsequently underwent surgical excision of the cyst. We compared the MRI diagnosis with the intra-operative findings and the histological evaluation of the surgical specimen to determine the accuracy of MRI in identifying an occult ganglion. When intra-operative determination of disease was used as a standard, the sensitivity of MRI scanning was 83%, the specificity was 50%, the positive predictive value was 94% and the accuracy 80%. Using histology as the standard, the sensitivity was 80%, the specificity 20%, and the positive predictive value 75%.
隐匿性小的腕背侧腱鞘囊肿，肉眼不可见或触不到，但可能会引起疼痛。临床上，舟月韧带处有压痛，腕关节过伸时疼痛，X线片正常且其他检查也无异常。我们回顾了20例疑似隐匿性腱鞘囊肿的患者，这些患者均接受了MRI扫描，随后进行了囊肿手术切除。我们将MRI诊断结果与术中发现以及手术标本的组织学评估进行比较，以确定MRI在识别隐匿性腱鞘囊肿方面的准确性。以术中疾病判定为标准时，MRI扫描的敏感性为83%，特异性为50%，阳性预测值为94%，准确性为80%。以组织学为标准时，敏感性为80%，特异性为20%，阳性预测值为75%。
