评估无症状患者的肱二头肌远端肌腱的 MRI 信号变化。
Evaluation of MRI Signal Changes of the Distal Biceps Tendon in Asymptomatic Patients.
机构信息
Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Belgium.
Department of Orthopedic Surgery, OLVG, Amsterdam, the Netherlands; Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
出版信息
J Hand Surg Am. 2022 May;47(5):454-459. doi: 10.1016/j.jhsa.2022.01.020. Epub 2022 Mar 25.
PURPOSE
Magnetic resonance imaging (MRI) is used widely for complete ruptures of the distal biceps tendon. The validity of this investigation for bicipital bursitis and tendinosis is unknown. The purpose of present study was to assess the prevalence of incidental (asymptomatic) signal changes in the distal biceps tendon in patients who underwent MRI including the elbow. Our null hypothesis was that signal changes of the distal biceps tendon do not occur in asymptomatic patients. This would empower MRI as a diagnostic tool for bicipital bursitis and tendinosis as well as complete and partial distal biceps tendon ruptures.
METHODS
We evaluated 1,191 elbow MRI scans including the distal biceps tendon insertion. The prevalence of incidental findings was calculated and sensitivity, specificity, positive predictive value, negative predictive value, false positive probability, and false negative probability were calculated.
RESULTS
Signal changes of the distal biceps tendon or bursitis were identified in 8 of 1,191 asymptomatic patients (prevalence 0.6%). The sensitivity of MRI for distal biceps pathology was 97% (95% confidence interval [CI], 93%-99%), specificity 99% (95% CI, 98%-99%), positive predictive value 94% (95% CI, 89%-97%), negative predictive value 99% (95% CI, 99%-99%), false positive probability 6% (95% CI, 3%-10%), and false negative probability 0.3% (95% CI, 0.1%-0.9%). There was no correlation between explanatory variables, including age, sex, race, occupation, and inflammatory disease and incidental distal biceps tendon signal changes.
CONCLUSIONS
The prevalence of distal biceps tendon signal changes on MRI in asymptomatic patients is very low.
CLINICAL RELEVANCE
The negative predictive value of 99% shows that patients without signal changes on MRI may be assumed to have no distal biceps tendon pathology. MRI investigation of distal biceps tendon is a valuable tool in the diagnosis of tendinosis and bicipital bursitis.
目的
磁共振成像（MRI）广泛用于诊断完全性肱二头肌远端肌腱撕裂。但目前对于 MRI 诊断肱二头肌滑囊炎和肌腱病的有效性还不清楚。本研究旨在评估无症状（无明显症状）患者的肱二头肌远端肌腱在接受包括肘部在内的 MRI 检查时出现的偶发性（非特异性）信号变化的发生率。我们的零假设是无症状患者的肱二头肌远端肌腱不会出现信号变化。如果这一假设成立，那么 MRI 检查将可作为肱二头肌滑囊炎和肌腱病以及完全性和部分性肱二头肌远端肌腱撕裂的诊断工具。
方法
我们评估了 1191 例包括肱二头肌远端肌腱止点的肘部 MRI 扫描。计算了偶发发现的发生率，并计算了敏感性、特异性、阳性预测值、阴性预测值、假阳性概率和假阴性概率。
结果
在 1191 例无症状患者中，有 8 例（发生率为 0.6%）出现了肱二头肌远端肌腱或滑囊炎的信号变化。MRI 对肱二头肌病变的敏感性为 97%（95%置信区间 [CI]，93%-99%），特异性为 99%（95% CI，98%-99%），阳性预测值为 94%（95% CI，89%-97%），阴性预测值为 99%（95% CI，99%-99%），假阳性率为 6%（95% CI，3%-10%），假阴性率为 0.3%（95% CI，0.1%-0.9%）。年龄、性别、种族、职业和炎症性疾病等解释变量与肱二头肌远端肌腱信号变化之间均无相关性。
结论
无症状患者的 MRI 检查中肱二头肌远端肌腱信号变化的发生率非常低。
临床相关性
阴性预测值为 99%，这表明 MRI 检查无信号变化的患者可假定没有肱二头肌远端肌腱病变。MRI 检查肱二头肌远端肌腱是诊断肌腱病和肱二头肌滑囊炎的有效工具。
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