肩胛下肌撕裂的放射学评估中的诊断难点。
Diagnostic difficulties in the radiological assessment of subscapularis tears.
作者信息
Ward Jonathan R N, Lotfi Naeil, Dias Richard G, McBride Timothy J
机构信息
New Cross Hospital, Wolverhampton Road, Heath Town, Wolverhampton WV10 0QP, United Kingdom.
出版信息
J Orthop. 2018 Jan 16;15(1):99-101. doi: 10.1016/j.jor.2018.01.016. eCollection 2018 Mar.
Abstract
BACKGROUND
Radiological evaluation of rotator cuff tears are sensitive and specific. Accuracy may be low in diagnosing subscapularis tears.
MATERIALS AND METHODS
We retrospectively reviewed shoulder arthroscopies performed by two surgeons over 45 months. We reviewed patients who had subscapularis repairs and their preoperative imaging.
RESULT
286 cases had imaging (193 MRIs, 93 USS) with 77 subscapularis repairs. MRI suggested 31 tears, arthroscopy confirmed 16 (30% sensitivity, 89% specificity). USS suggested 6 tears, arthroscopy confirmed 4 (13% Sensitivity, 97% specificity).
DISCUSSION
Results demonstrated low accuracy for preoperative radiological subscapularis tear assessment. This has logistical, diagnostic and implications on treatment.
摘要
背景
肩袖撕裂的放射学评估具有敏感性和特异性。在诊断肩胛下肌撕裂时准确性可能较低。
材料与方法
我们回顾性分析了两位外科医生在45个月内进行的肩关节镜检查。我们研究了接受肩胛下肌修复的患者及其术前影像学检查。
结果
286例患者进行了影像学检查（193例磁共振成像，93例超声检查），其中77例进行了肩胛下肌修复。磁共振成像提示31例撕裂，关节镜检查证实16例（敏感性30%，特异性89%）。超声检查提示6例撕裂，关节镜检查证实4例（敏感性为13%，特异性为97%）。
讨论
结果表明术前放射学评估肩胛下肌撕裂的准确性较低。这在后勤、诊断及治疗方面均有影响。
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本文引用的文献
1
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Arthrosc Tech. 2013 Oct 7;2(4):e373-9. doi: 10.1016/j.eats.2013.05.007. eCollection 2013.
2
Why repair the subscapularis? A logical rationale.为什么要修复肩胛下肌？一个合理的基本原理。
Arthroscopy. 2011 Aug;27(8):1123-8. doi: 10.1016/j.arthro.2011.03.001. Epub 2011 Jun 24.
3
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4
The abduction external rotation (ABER) view for MRI of the shoulder.用于肩部MRI的外展外旋（ABER）位片。
Orthopedics. 2010 Aug;33(8):562-5. doi: 10.3928/01477447-20100625-17.
5
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AJR Am J Roentgenol. 2009 Jun;192(6):1701-7. doi: 10.2214/AJR.08.1241.
6
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J Bone Joint Surg Am. 2007 Jun;89(6):1184-93. doi: 10.2106/JBJS.F.00007.
7
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8
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9
10
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Am J Sports Med. 2003 Sep-Oct;31(5):744-50. doi: 10.1177/03635465030310051801.
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