Iannotti J P, Zlatkin M B, Esterhai J L, Kressel H Y, Dalinka M K, Spindler K P
Department of Orthopaedic Surgery, University of Pennsylvania, School of Medicine, Philadelphia 19104.
J Bone Joint Surg Am. 1991 Jan;73(1):17-29.
The sensitivity, specificity, and predictive value of magnetic resonance imaging in the diagnosis of lesions of the rotator cuff, glenohumeral capsule, and glenoid labrum were evaluated in ninety-one patients and fifteen asymptomatic volunteers. Magnetic resonance imaging demonstrated 100 per cent sensitivity and 95 per cent specificity in the diagnosis of complete tears, and it consistently predicted the size of the tear of the rotator cuff. There was a definite correlation between atrophy of the supraspinatus muscle and the size of a complete, chronic tear of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the differentiation of tendinitis from degeneration of the cuff were 82 and 85 per cent, and in the differentiation of a normal tendon from one affected by tendinitis with signs of impingement the sensitivity and specificity were 93 and 87 per cent. The formation of spurs around the acromion and acromiocalvicular joint correlated highly with increased age of the patient and with chronic disease of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the diagnosis of labral tears associated with glenohumeral instability were 88 and 93 per cent. The study showed that high-resolution magnetic-resonance imaging is an excellent non-invasive tool in the diagnosis of lesions of the rotator cuff and glenohumeral instability.
对91例患者和15名无症状志愿者评估了磁共振成像在诊断肩袖、盂肱关节囊和盂唇损伤中的敏感性、特异性和预测价值。磁共振成像在诊断完全撕裂方面显示出100%的敏感性和95%的特异性,并且始终能预测肩袖撕裂的大小。冈上肌萎缩与肩袖完全慢性撕裂的大小之间存在明确的相关性。磁共振成像在区分肌腱炎与肩袖退变方面的敏感性和特异性分别为82%和85%,在区分正常肌腱与受撞击征肌腱炎影响的肌腱方面的敏感性和特异性分别为93%和87%。肩峰和肩锁关节周围骨赘的形成与患者年龄增加和肩袖慢性疾病高度相关。磁共振成像在诊断与盂肱关节不稳相关的盂唇撕裂方面的敏感性和特异性分别为88%和93%。该研究表明,高分辨率磁共振成像是诊断肩袖损伤和盂肱关节不稳的一种出色的非侵入性工具。