Jeong Woo Kyoung, Ah Ryu Jeong, Choi Seung Hong, Choi Jun-ho, Ho Kim Seung, Kim Jinoo, Lee Seunghun
Department of Radiology, Armed Forces Capital Hospital, San 13-1, Yul-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-040, Republic of Korea.
J Clin Ultrasound. 2013 Feb;41(2):94-100. doi: 10.1002/jcu.21981. Epub 2012 Sep 20.
To compare shoulder sonography (US) after intraarticular fluid injection ("arthrosonography") with conventional shoulder US for diagnosing anterior labral tears.
Thirty consecutive patients who were to undergo shoulder MR arthrography were enrolled after written informed consent was obtained. A radiologist performed conventional US, using a 2- to 5-MHz convex transducer on the subject whose arm was externally rotated, then abducted perpendicular to the trunk, and rotated internally and externally. After intraarticular injection of diluted gadolinium contrast for MR arthrography, arthrosonography was performed in the same manner as in the conventional method. Two other radiologists compared the two US methods in the diagnosis of anterior labral tears using a five-point scale. Receiver operating characteristic (ROC) curves and weighted kappa values were calculated.
Fourteen patients proven to have anterior labral tears by arthroscopy constituted the disease group, and 16 patients, including the 4 patients who were negative on arthroscopy, constituted the normal group. The areas under the ROC curve of arthrosonography (mean, 0.977) were larger than those of conventional US (mean, 0.858). The kappa values for assessing the interobserver agreement of the two modalities were 0.40 and 0.82, respectively.
Arthrosonography of the shoulder is more accurate and reliable than conventional US for diagnosing anterior labral tear.
比较关节内注射液体后肩部超声检查（超声）与传统肩部超声检查在诊断前盂唇撕裂方面的效果。
在获得书面知情同意后，连续纳入30例拟行肩部磁共振关节造影的患者。放射科医生采用2至5兆赫的凸阵探头对患者进行传统超声检查，检查时患者手臂外旋，然后垂直于躯干外展，并进行内旋和外旋。在关节内注射稀释的钆对比剂用于磁共振关节造影后，以与传统方法相同的方式进行关节超声检查。另外两名放射科医生使用五点量表比较两种超声检查方法在诊断前盂唇撕裂方面的效果。计算受试者操作特征（ROC）曲线和加权kappa值。
经关节镜检查证实有前盂唇撕裂的14例患者构成疾病组，16例患者（包括关节镜检查阴性的4例患者）构成正常组。关节超声检查的ROC曲线下面积（平均0.977）大于传统超声检查（平均0.858）。评估两种检查方法观察者间一致性的kappa值分别为0.40和0.82。
肩部关节超声检查在诊断前盂唇撕裂方面比传统超声检查更准确、可靠。
