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超声对肩痛患者肩袖损伤疾病诊断准确性的评估

Evaluation of Diagnostic Precision of Ultrasound for Rotator Cuff Disorders in Patients with Shoulder Pain.

作者信息

Aminzadeh Behzad, Najafi Samane, Moradi Ali, Abbasi Bita, Farrokh Donya, Emadzadeh Maryam

机构信息

Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Arch Bone Jt Surg. 2020 Nov;8(6):689-695. doi: 10.22038/abjs.2020.42894.2166.

Abstract

BACKGROUND

Rotator cuff disorders are a leading cause of shoulder symptoms. Accurate imaging, detecting the type of the involved muscle, and severity of the injury have important effects on the choice of treatment. Accordingly, the current study was conducted to evaluate the diagnostic accuracy of ultrasound for rotator cuff disorders in patients suffering from shoulder pain and to explore the precision of ultrasound in determining the exact dimensions of a tear in comparison with magnetic resonance imaging (MRI).

METHODS

This prospective research was performed on patients clinically suspected of rotator cuff tendinopathy. An ultrasound of the shoulder was initially performed for the candidates. In this study, MRI was regarded as the modality of choice for examining the images of shoulder disorders. The European Society of Musculoskeletal Radiology (ESSR) guidelines were used to design the protocols and implement imaging measures. Based on the reference standard of MRI, the specificity and sensitivity as well as positive and negative predictive values of ultrasound in detection of rotator cuff disorders were calculated.

RESULTS

A total of48 patients (22 women, 23 dominant right hands) with an average age of 51.6±8.3 years were enrolled in this study. Based on MRI findings, rotator cuff disorders were detected in 43 patients (89.5%). The most commonly observed disorders were partial-thickness rotator cuff tear (n=17, 35.4%), full-thickness rotator cuff tear (n=16, 33.3%), and tendinopathy (n=10, 20.8%). Among rotator cuff disorders, the highest sensitivity of ultrasound was observed in the detection of full-thickness tear (93.7%) and rotator cuff tendinopathy (90%). The highest specificity was found in the detection of full-thickness rotator cuff tear (100%) and partial-thickness rotator cuff tear (96.7%).

CONCLUSION

Based on our findings, ultrasound could be considered as a high-quality diagnostic tool to rule in partial and full-thickness rotator cuff tears and rule out the rotator cuff pathologies.

摘要

背景

肩袖疾病是肩部症状的主要原因。准确的影像学检查,确定受累肌肉的类型以及损伤的严重程度,对治疗方案的选择具有重要影响。因此,本研究旨在评估超声对肩痛患者肩袖疾病的诊断准确性,并与磁共振成像(MRI)相比,探讨超声在确定撕裂确切尺寸方面的精确性。

方法

本前瞻性研究针对临床怀疑患有肩袖肌腱病的患者进行。首先对候选患者进行肩部超声检查。在本研究中,MRI被视为检查肩部疾病图像的首选方式。采用欧洲肌肉骨骼放射学会(ESSR)指南来设计方案并实施成像措施。基于MRI的参考标准,计算超声检测肩袖疾病的特异性、敏感性以及阳性和阴性预测值。

结果

本研究共纳入48例患者(22例女性,23例优势右手),平均年龄51.6±8.3岁。根据MRI结果,43例患者(89.5%)检测出肩袖疾病。最常见的疾病为部分厚度肩袖撕裂(n = 17,35.4%)、全层肩袖撕裂(n = 16,33.3%)和肌腱病(n = 10,20.8%)。在肩袖疾病中,超声检测全层撕裂(93.7%)和肩袖肌腱病(90%)时敏感性最高。检测全层肩袖撕裂(100%)和部分厚度肩袖撕裂(96.7%)时特异性最高。

结论

基于我们的研究结果,超声可被视为一种高质量的诊断工具,用于确诊部分厚度和全层肩袖撕裂,并排除肩袖病变。

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