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磁共振成像对肩袖撕裂患者肱二头肌长头部分撕裂的诊断准确性

Diagnostic accuracy of magnetic resonance imaging for partial tears of the long head of the biceps tendon in patients with rotator cuff tears.

作者信息

Shibayama Yuji, Hirose Toshiaki, Sugi Akira, Mizushima Emi, Watanabe Yuto, Tomii Rira, Iba Kousuke, Yamashita Toshihiko

机构信息

Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

Asabu Orthopaedic Hospital, Sapporo, Hokkaido, Japan.

出版信息

JSES Int. 2022 Apr 4;6(4):638-642. doi: 10.1016/j.jseint.2022.03.001. eCollection 2022 Jul.

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) is useful for diagnosing shoulder diseases preoperatively. However, detection of partial tears of the long head of the biceps tendon (LHBT) using current clinical tests and imaging modalities is difficult. We aimed to evaluate the accuracy of radial-slice MRI for diagnosing partial tears of the LHBT. We hypothesized that radial-slice MRI may be a valuable diagnostic tool for assessing diagnosing tears of the LHBT.

METHODS

We retrospectively investigated 118 patients who underwent shoulder arthroscopy for rotator cuff tears. Intraoperative LHBT findings were compared with the identification of partial tears of the LHBT on conventional-slice MRI and radial-slice MRI, using a 3.0-T system. We calculated sensitivity, specificity, accuracy, and positive and negative predictive values for the detection of LHBT tears. Inter- and intraobserver reliability for radial-slice MRI was calculated using kappa statistics.

RESULTS

We diagnosed 69 patients (58%) without any LHBT tears and 49 with partial tears (42%), arthroscopically. Sensitivity, specificity, accuracy, and positive and negative predictive values of conventional-slice MRI for detection of partial tears of the LHBT were 52%, 94%, 78%, 92%, and 58%, respectively. Radial-slice MRI had 84% sensitivity, 90% specificity, 86% accuracy, and 92% positive and 80% negative predictive values for partial tears of the LHBT. Inter- and intraobserver reliability for radial-slice MRI was 0.69 and 0.74, respectively, corresponding to high reproducibility and defined as good.

CONCLUSION

Radial-slice MRI demonstrated significantly higher sensitivity than conventional-slice MRI. These results indicate that radial-slice MRI is useful for diagnosing LHBT partial tears.

摘要

背景

磁共振成像(MRI)有助于术前诊断肩部疾病。然而,使用当前的临床检查和成像方式检测肱二头肌长头肌腱(LHBT)的部分撕裂很困难。我们旨在评估桡侧切片MRI诊断LHBT部分撕裂的准确性。我们假设桡侧切片MRI可能是评估LHBT撕裂的一种有价值的诊断工具。

方法

我们回顾性研究了118例因肩袖撕裂接受肩关节镜检查的患者。使用3.0-T系统,将术中LHBT的检查结果与传统切片MRI和桡侧切片MRI上LHBT部分撕裂的识别结果进行比较。我们计算了检测LHBT撕裂的敏感性、特异性、准确性以及阳性和阴性预测值。使用kappa统计量计算桡侧切片MRI的观察者间和观察者内可靠性。

结果

通过关节镜检查,我们诊断出69例(58%)患者没有任何LHBT撕裂,49例(42%)有部分撕裂。传统切片MRI检测LHBT部分撕裂的敏感性、特异性、准确性以及阳性和阴性预测值分别为52%、94%、78%、92%和58%。桡侧切片MRI对LHBT部分撕裂的敏感性为84%,特异性为90%,准确性为86%,阳性预测值为92%,阴性预测值为80%。桡侧切片MRI的观察者间和观察者内可靠性分别为0.69和0.74,对应于高重复性,定义为良好。

结论

桡侧切片MRI的敏感性明显高于传统切片MRI。这些结果表明桡侧切片MRI有助于诊断LHBT部分撕裂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c844/9264005/9f3ec317bcc6/gr1.jpg

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