Porta Marco, La Marca Salvatore, Carapella Nicola, Surace Alessandra, Fanciullo Cristiana, Simonini Roberto, Sironi Sandro, Albano Domenico, Messina Carmelo, Sconfienza Luca Maria, Aliprandi Alberto
Department of Radiology, Istituti Clinici Zucchi, 20052 Monza, Italy.
Department of Radiology, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
Diagnostics (Basel). 2023 Jan 28;13(3):483. doi: 10.3390/diagnostics13030483.
We aimed to demonstrate the applicability of Snyder's arthroscopic classification of rotator cuff tears (RCT) in shoulder ultrasound (US) and to compare it with MR arthrography (MRA). Forty-six patients (34 males; mean age:34 ± 14 years) underwent shoulder US and MRA. Two radiologists (R1 = 25 years of experience; R2 = 2 years of experience) assigned A1-4, B1-4, or C1-4 values depending on the extent of RCT in both US and MRA. Inter-reader intra-modality and intra-reader inter-modality agreement were calculated using Cohen's kappa coefficient. US sensitivity and specificity of both readers were calculated using MRA as the gold standard. Patients were divided into intact cuff vs. tears, mild (A1/B1) vs. moderate (A2-3/B2-3) tears, mild-moderate (A2/B2) vs. high-moderate (A3/B3) cuff tears, moderate (A2-3/B2-3) vs. advanced (A4/B4) and full-thickness (C) tears. The highest agreement values in inter-reader US evaluation were observed for mild-moderate vs. high-moderate RCT (K = 0.745), in inter-reader MRA evaluation for mild vs. moderate RCT (K = 0.821), in R1 inter-modality (US-MRA) for mild-moderate vs. high-moderate and moderate vs. advanced/full-thickness RCT (K = 1.000), in R2 inter-modality (US-MRA) for moderate vs. advanced/full-thickness RCT (K = 1.000). US sensitivity ranged from 88.89%(R1)-84.62%(R2) to 100% (both readers), while specificity from 77.78%(R1)-90.00%(R2) to 100% (both readers). Snyder's classification can be used in US to ensure the correct detection and characterization of RCT.
我们旨在证明斯奈德（Snyder）的肩袖撕裂（RCT）关节镜分类法在肩部超声（US）中的适用性，并将其与磁共振关节造影（MRA）进行比较。46例患者（34例男性；平均年龄：34±14岁）接受了肩部超声和MRA检查。两名放射科医生（R1有25年经验；R2有2年经验）根据RCT在美国和MRA中的程度分别指定A1 - 4、B1 - 4或C1 - 4值。使用科恩（Cohen）kappa系数计算阅片者间的模态内一致性和阅片者内的模态间一致性。以MRA作为金标准计算两位阅片者的美国超声敏感性和特异性。患者被分为完整肩袖与撕裂、轻度（A1/B1）与中度（A2 - 3/B2 - 3）撕裂、轻度 - 中度（A2/B2）与高度 - 中度（A3/B3）肩袖撕裂、中度（A2 - 3/B2 - 3）与重度（A4/B4）以及全层（C）撕裂。在阅片者间的美国超声评估中，轻度 - 中度与高度 - 中度RCT的一致性值最高（K = 0.745）；在阅片者间的MRA评估中，轻度与中度RCT的一致性值最高（K = 0.821）；在R1的模态间（超声 - MRA）评估中，轻度 - 中度与高度 - 中度以及中度与重度/全层RCT的一致性值最高（K = 1.000）；在R2的模态间（超声 - MRA）评估中，中度与重度/全层RCT的一致性值最高（K = 1.000）。美国超声的敏感性范围为88.89%（R1） - 84.62%（R2）至100%（两位阅片者），而特异性范围为77.78%（R1） - 90.00%（R2）至100%（两位阅片者）。斯奈德分类法可用于美国超声检查，以确保正确检测和鉴别RCT。
