Friedman R L, Hidalgo H J, Gilmer P W, Mallon W J
From Durham Radiology Associates and Triangle Orthopaedic Associates, Durham; and the Division of Orthopaedic Surgery, Duke Medical Center.
J Shoulder Elbow Surg. 1993 Jan;2(1):22-6. doi: 10.1016/S1058-2746(09)80133-X. Epub 2009 Feb 19.
Forty-six patients underwent ultrasonogrophy evaluation of their shoulder for suspected rotator cuff tears from 1989 to 1992. All ultrasound studies were evaluated by a radiologist (HJH) who was not subspecialty-trained in shoulder ultrasonography. All patients had surgical confirmation of the status of their tendons. A statistical analysis of the accuracy of ultrasound in detecting rotator cuff tearing was performed. The sensitivity was 81%, and the specificity was 100%; there was a positive predictive value of 100% and a negative predictive value of 71%. Using strict sonographic criteria for diagnosing a rotator cuff tear, we conclude that ultrasound can detect intermediate or large rotator cuff tears with great accuracy (19 of 20 shoulders). Accuracy decreases dramatically in the presence of a small tear (six of 11 shoulders). At our hospital the cost of ultrasound examination of the shoulder is 0.19 the cost of magnetic resonance imaging of the shoulder and is 0.62 the cost of a shoulder arthrogrom. Ultrasound of the shoulder should be considered for imaging the rotator cuff because of its accuracy, low cost, and high patient satisfaction. It can be reliably performed by radiologists with state-of-the-art equipment who are interested in and have experience with the procedure.
1989年至1992年期间，46例患者因疑似肩袖撕裂接受了肩部超声检查评估。所有超声检查均由一位未接受过肩部超声专科培训的放射科医生（HJH）进行评估。所有患者均通过手术确定了其肌腱的状况。对超声检测肩袖撕裂的准确性进行了统计分析。敏感性为81%，特异性为100%；阳性预测值为100%，阴性预测值为71%。采用严格的超声诊断标准诊断肩袖撕裂，我们得出结论，超声能够非常准确地检测出中等或大型肩袖撕裂（20个肩部中的19个）。在存在小撕裂的情况下，准确性会大幅下降（11个肩部中的6个）。在我们医院，肩部超声检查的费用是肩部磁共振成像费用的0.19倍，是肩部关节造影费用的0.62倍。由于其准确性、低成本以及高患者满意度，肩部超声检查应被视为肩袖成像的一种方法。配备先进设备且对该检查感兴趣并有经验的放射科医生能够可靠地进行此项检查。
