Awasthi Prateek, Dwivedi Abhishek, Choudhary Satveer S
Department of Radiodiagnosis, Military Hospital, Agra, Uttar Pradesh, India.
Department of Radiodiagnosis, FH Medical College and Hospital, Agra, Uttar Pradesh, India.
Adv Biomed Res. 2025 Jul 21;14:55. doi: 10.4103/abr.abr_347_23. eCollection 2025.
Imaging continues to have a crucial role in evaluating patients with shoulder pain, helping to make treatment choices. Magnetic resonance arthrography (MRA), rather than magnetic resonance imaging (MRI), is now routinely used to diagnose shoulder injuries. Against the gold standard investigation of arthroscopy, the study aimed to determine the accuracy of MRA in the evaluation of shoulder injuries.
From June 2017 to May 2019, a cross-sectional study was conducted in a tertiary care health setup in North India. A total of 50 individuals were enrolled for diagnostic imaging with rotator cuff (RC) pathology. Patients were assessed using an MRA and their clinical history. In comparison with the gold standard for arthroscopy, the sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA) of MRA for diagnosing shoulder injuries were evaluated. A value under 0.05 was taken to be statistically significant.
The mean ± standard deviation (SD) age of the patients was 37.32 ± 12.78 years. There were seven women and 43 (86%) men. The different lesions were superior labral anterior-posterior (SLAP) tear (24 (48%)), Bankart lesions (19 (38%)), anterior labral periosteal sleeve avulsion (ALSPA) (4 (8%)), partial articular supraspinatus tendon avulsion (PASTA) lesion (2 (4%)), and Buford lesions (1 (2%)). The Sn, PPV, and DA of MRA were 98%, 100%, and 98%, respectively, for identifying the shoulder injury.
It was concluded that MRA was reasonably accurate at diagnosing shoulder injuries. MRA demonstrated an excellent 98% Sn in identifying shoulder injuries and missed only one case of shoulder injury, suggesting that it can be an advantageous imaging tool for recognizing and evaluating shoulder injuries for immediate diagnosis and management.
影像学在评估肩部疼痛患者及辅助治疗决策方面仍起着关键作用。目前，磁共振关节造影（MRA）而非磁共振成像（MRI）被常规用于诊断肩部损伤。本研究旨在对照关节镜这一金标准检查，确定MRA在评估肩部损伤时的准确性。
2017年6月至2019年5月，在印度北部的一家三级医疗保健机构开展了一项横断面研究。共有50例患有肩袖（RC）病变的患者纳入诊断性成像研究。采用MRA及患者临床病史对患者进行评估。对照关节镜金标准，评估MRA诊断肩部损伤的敏感度（Sn）、阳性预测值（PPV）及诊断准确性（DA）。P值小于0.05被认为具有统计学意义。
患者的平均年龄±标准差为37.32±12.78岁。其中女性7例，男性43例（86%）。不同病变包括上盂唇前后（SLAP）撕裂（24例（48%））、Bankart损伤（19例（38%））、前盂唇骨膜袖套撕脱（ALSPA）（4例（8%））、部分关节面冈上肌腱撕脱（PASTA）病变（2例（4%））及布福德病变（1例（2%））。MRA诊断肩部损伤的Sn、PPV及DA分别为98%、100%和98%。
研究得出结论，MRA在诊断肩部损伤方面具有合理的准确性。MRA在识别肩部损伤时显示出高达98%的优异敏感度，仅漏诊1例肩部损伤，这表明它可能是一种用于识别和评估肩部损伤以进行即时诊断和处理的优势成像工具。
