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关节镜下肩袖修复术后早期超声检查的可预测性

Predictability of Early Postoperative Ultrasonography After Arthroscopic Rotator Cuff Repair.

作者信息

Oh Joo Han, Kim Joon Yub, Kim Sae Hoon, Chung Nam Yun

出版信息

Orthopedics. 2017 Nov 1;40(6):e975-e981. doi: 10.3928/01477447-20170918-06. Epub 2017 Sep 22.

Abstract

The predictability of early postoperative ultrasonography (USG) for evaluating the structural integrity of repaired rotator cuffs is still unclear. The aim of this study was to compare the predictability of early USG performed 3 and 6 months postoperatively with magnetic resonance imaging (MRI) performed 1 year after arthroscopic cuff repair for structural failure. Among 213 patients who had arthroscopic rotator cuff surgery in 2013, one hundred thirty-eight patients who underwent USG between 3 and 6 months postoperatively and MRI at 1 year postoperatively were enrolled; the postoperative MRI findings were the reference standard used for the comparison. One hundred one patients who were examined using USG at 3 months postoperatively were allocated to group A, and 108 patients who had USG at 6 months postoperatively were allocated to group B. All diagnostic values, including positive and negative predictabilities, were calculated by 2-way tables. To compare the sensitivity and specificity between groups A and B, the area under the curve was calculated from the receiver operator characteristic curve for each group. The positive predictability values were 86.36% and 93.51% for USG at 3 and 6 months postoperatively, respectively. The negative values were 84.21% and 95.83%, respectively. The areas under the receiver operator characteristic curves for groups A and B were 0.853 and 0.947, respectively (P=.048). Although the predictability of a single USG at 3 months postoperatively reached approximately 85%, USG evaluation at 6 months postoperatively might be relevant for predicting structural failure after arthroscopic rotator cuff repair. [Orthopedics. 2017; 40(6):e975-e981.].

摘要

术后早期超声检查(USG)评估修复后的肩袖结构完整性的可预测性仍不明确。本研究的目的是比较术后3个月和6个月进行的早期USG与关节镜下肩袖修复术后1年进行的磁共振成像(MRI)对结构失败的可预测性。在2013年接受关节镜下肩袖手术的213例患者中,138例在术后3至6个月接受了USG检查,并在术后1年接受了MRI检查;术后MRI结果作为比较的参考标准。101例术后3个月接受USG检查的患者被分配到A组,108例术后6个月接受USG检查的患者被分配到B组。所有诊断值,包括阳性和阴性预测值,均通过双向表计算。为比较A组和B组之间的敏感性和特异性,根据每组的受试者操作特征曲线计算曲线下面积。术后3个月和6个月USG的阳性预测值分别为86.36%和93.51%。阴性值分别为84.21%和95.83%。A组和B组受试者操作特征曲线下面积分别为0.853和0.947(P = 0.048)。尽管术后3个月单次USG的可预测性达到约85%,但术后6个月的USG评估可能与预测关节镜下肩袖修复术后的结构失败有关。[《骨科》。2017;40(6):e975 - e981。]

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