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间接磁共振关节造影在诊断盂唇损伤方面能否成为磁共振成像的良好替代方法?一项前瞻性研究。

Can indirect magnetic resonance arthrography be a good alternative to magnetic resonance imaging in diagnosing glenoid labrum lesions?: a prospective study.

作者信息

Mardani-Kivi Mohsen, Alizadeh Ahmad, Asadi Kamran, Izadi Amin, Leili Ehsan Kazemnejad, Arzpeyma Sima Fallah

机构信息

Orthopaedic Research Center, Department of Orthopaedics, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Clin Shoulder Elb. 2022 Sep;25(3):182-187. doi: 10.5397/cise.2021.00598. Epub 2022 Jun 14.

Abstract

BACKGROUND

This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other.

METHODS

This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form.

RESULTS

Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were 77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%.

CONCLUSIONS

Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions.

摘要

背景

本研究旨在评估和比较磁共振成像(MRI)和间接磁共振关节造影(I-MRA)成像与关节镜检查的诊断价值以及它们彼此之间的诊断价值。

方法

本描述性分析研究于2020年进行。当年所有经检测盂唇损伤呈阳性的患者均纳入研究。患者接受了6周的保守治疗。若对保守治疗无反应,则进行MRI和I-MRA成像,并对患者进行关节镜检查以确定其最终诊断和治疗方案。由一位经验丰富的肌肉骨骼放射科医生每隔1周评估一次成像结果。图像解读结果和关节镜检查结果记录在数据收集表中。

结果

总体而言,35名患者纳入了本研究。基于kappa系数,结果表明两种成像方法的结果均与关节镜检查结果一致,但I-MRA的一致性率高于MRI(分别为0.612±0.157和0.749±0.101,而MRI为0.449±0.160和0.603±0.113)。MRI检测盂唇撕裂的灵敏度、特异度、阴性预测值、阳性预测值和准确度分别为77.77%、75.00%、91.30%、50.00%和77.14%,I-MRA的分别为88.88%、75.00%、92.30%、66.66%和85.71%。

结论

在此,I-MRA对盂唇撕裂的诊断价值高于MRI。因此,若有潜在盂唇损伤的指征,建议使用I-MRA而非MRI。

相似文献

本文引用的文献

1
Histology, vascularity and innervation of the glenoid labrum.肩胛盂唇的组织学、血管分布和神经支配
J Orthop Surg (Hong Kong). 2018 May-Aug;26(2):2309499018770900. doi: 10.1177/2309499018770900.
3
Imaging the Glenoid Labrum and Labral Tears.肩关节盂唇及唇撕裂的影像学检查
Radiographics. 2016 Oct;36(6):1628-1647. doi: 10.1148/rg.2016160020.
4
Moderate value of non-contrast magnetic resonance imaging after non-dislocating shoulder trauma.非脱位性肩部创伤后非增强磁共振成像的中等价值。
Knee Surg Sports Traumatol Arthrosc. 2016 Jun;24(6):1888-95. doi: 10.1007/s00167-014-3102-6. Epub 2014 Jun 13.

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