Bayer Thomas, Fries Simon, Schweizer Andreas, Schöffl Isabelle, Janka Rolf, Bongartz Georg
Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany,
Skeletal Radiol. 2015 Jan;44(1):77-84. doi: 10.1007/s00256-014-2002-7. Epub 2014 Sep 25.
The objectives of this study were the evaluation of flexor tendon pulley rupture of the fingers in the crimp grip position using magnetic resonance imaging (MRI) and the comparison of the results with MRI in the neutral position in a cadaver study.
MRI in the crimp grip position and in the neutral position was performed in 21 cadaver fingers with artificially created flexor tendon pulley tears (combined pulley rupture, n = 14; single pulley rupture, n = 7). Measurement of the distance between the tendon and bone was performed. Images were evaluated by two readers, first independently and in cases of discrepancy in consensus. Sensitivity and specificity for detecting combined pulley ruptures were calculated.
Tendon bone distances were significantly higher in the crimp grip position than in the neutral position. Sensitivity and specificity for detecting combined pulley rupture were 92.86 % and 100 % respectively in the crimp grip position and 78.57 % and 85.71 % respectively in the neutral position. Kappa values for interobserver reliability were 0.87 in the crimp grip position and 0.59 in the neutral position.
MRI examination in the crimp grip position results in higher tendon bone distances by subjecting the pulleys to a higher strain, which facilitates image evaluation with higher interobserver reliability, higher sensitivity, and higher specificity for combined pulley rupture compared with examination in the neutral position.
本研究的目的是在尸体研究中，使用磁共振成像（MRI）评估手指在紧握位时屈肌腱滑车破裂情况，并将结果与中立位时的MRI结果进行比较。
对21根有人为制造的屈肌腱滑车撕裂的尸体手指（联合滑车破裂14根；单滑车破裂7根）进行紧握位和中立位的MRI检查。测量肌腱与骨之间的距离。由两名阅片者进行图像评估，首先各自独立评估，意见不一致时达成共识。计算检测联合滑车破裂的敏感度和特异度。
紧握位时肌腱与骨的距离显著高于中立位。紧握位检测联合滑车破裂的敏感度和特异度分别为92.86%和100%，中立位时分别为78.57%和85.71%。观察者间可靠性的Kappa值在紧握位为0.87，在中立位为0.59。
与中立位检查相比，紧握位的MRI检查通过使滑车承受更高的应变，导致肌腱与骨的距离更高，这有利于图像评估，具有更高的观察者间可靠性、更高的敏感度和联合滑车破裂的特异度。
