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肩周炎患者MRI中肩袖病理假阳性的发生率

Incidence of False Positive Rotator Cuff Pathology in MRIs of Patients with Adhesive Capsulitis.

作者信息

Loeffler Bryan J, Brown Stephen L, D'Alessandro Donald F, Fleischli James E, Connor Patrick M

机构信息

Department of Orthopedic Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.

出版信息

Orthopedics. 2011 May 18;34(5):362. doi: 10.3928/01477447-20110317-14.

Abstract

The purpose of this study was to compare the incidence of presumed rotator cuff pathology based on radiologist and surgeon interpretation of preoperative magnetic resonance images (MRIs) with actual rotator cuff pathology found intraoperatively in patients undergoing arthroscopic capsular release for adhesive capsulitis.The medical records of 38 consecutive patients who underwent arthroscopic glenohumeral capsular release for adhesive capsulitis between September 2001 and May 2007 were retrospectively reviewed. Radiologist and surgeon predicted status of the rotator cuff by prospective MRI interpretation was compared to the actual status of the rotator cuff intraoperatively. Radiologists' preoperative MRI interpretations predicted a 57.9% incidence of rotator cuff pathology, while operative findings revealed a true incidence of only 13.2% (P<.0001). Radiologists accurately predicted the absence or presence of a rotator cuff tear in 19 of 38 cases (50%), compared to the surgeon, who correctly interpreted 29 of 38 MRIs (76.3%).Interpretations of shoulder MRIs in patients with adhesive capsulitis may provide misleading information regarding rotator cuff pathology. The actual findings of shoulder MRI scans may lead to the appearance of false rotator cuff pathology in this population, and a high percentage of false positive MRI reports of rotator cuff tears was observed in these patients. If MRI is chosen as a diagnostic adjunct in this patient population, careful consideration should be given to its interpretation to avoid unnecessary or possibly aggravating surgical intervention.

摘要

本研究的目的是比较放射科医生和外科医生对术前磁共振成像(MRI)的解读所推测的肩袖病变发生率与在接受关节镜下关节囊松解术治疗粘连性关节囊炎的患者术中发现的实际肩袖病变情况。回顾性分析了2001年9月至2007年5月期间连续38例接受关节镜下盂肱关节囊松解术治疗粘连性关节囊炎患者的病历。将放射科医生和外科医生通过前瞻性MRI解读预测的肩袖状态与术中肩袖的实际状态进行比较。放射科医生术前MRI解读预测肩袖病变发生率为57.9%,而手术结果显示实际发生率仅为13.2%(P<0.0001)。放射科医生在38例病例中的19例(50%)准确预测了肩袖撕裂的有无,相比之下,外科医生正确解读了38例MRI中的29例(76.3%)。粘连性关节囊炎患者肩部MRI的解读可能会提供有关肩袖病变的误导性信息。肩部MRI扫描的实际结果可能导致该人群中出现假性肩袖病变,并且在这些患者中观察到肩袖撕裂的MRI报告假阳性率很高。如果在该患者群体中选择MRI作为诊断辅助手段,则应仔细考虑其解读,以避免不必要的或可能加重病情的手术干预。

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