Sher J S, Uribe J W, Posada A, Murphy B J, Zlatkin M B
Department of Orthopaedics and Rehabilitation, University of Miami, Doctor's Hospital, Florida 33146.
J Bone Joint Surg Am. 1995 Jan;77(1):10-5. doi: 10.2106/00004623-199501000-00002.
Magnetic resonance images of the shoulders of ninety-six asymptomatic individuals were evaluated to determine the prevalence of findings consistent with a tear of the rotator cuff. The scans were reviewed independently by two diagnostic radiologists who are experienced in the interpretation of magnetic resonance images of the shoulder. The over-all prevalence of tears of the rotator cuff in all age-groups was 34 per cent (thirty-three). There were fourteen full-thickness tears (15 per cent) and nineteen partial-thickness tears (20 per cent). The frequency of full-thickness and partial-thickness tears increased significantly with age (p < 0.001 and 0.05, respectively). Twenty-five (54 per cent) of the forty-six individuals who were more than sixty years old had a tear of the rotator cuff: thirteen (28 per cent) had a full-thickness tear and twelve (26 per cent) had a partial-thickness tear. Of the twenty-five individuals who were forty to sixty years old, one (4 per cent) had a full-thickness tear and six (24 per cent) had a partial-thickness tear. Of the twenty-five individuals who were nineteen to thirty-nine years old, none had a full-thickness tear and one (4 per cent) had a partial-thickness tear. Magnetic resonance imaging identified a high prevalence of tears of the rotator cuff in asymptomatic individuals. These tears were increasingly frequent with advancing age and were compatible with normal, painless, functional activity. The results of the present study emphasize the potential hazards of the use of magnetic resonance imaging scans alone as a basis for the determination of operative intervention in the absence of associated clinical findings.
对96名无症状个体的肩部进行磁共振成像评估，以确定与肩袖撕裂相符的检查结果的患病率。扫描结果由两位在肩部磁共振成像解读方面经验丰富的诊断放射科医生独立审查。所有年龄组肩袖撕裂的总体患病率为34%（33例）。其中全层撕裂14例（15%），部分层撕裂19例（20%）。全层和部分层撕裂的发生率随年龄显著增加（分别为p<0.001和0.05）。46名60岁以上的个体中有25名（54%）存在肩袖撕裂：13名（28%）为全层撕裂，12名（26%）为部分层撕裂。在25名40至60岁的个体中，1名（4%）为全层撕裂，6名（24%）为部分层撕裂。在25名19至39岁的个体中，无人为全层撕裂，1名（4%）为部分层撕裂。磁共振成像显示无症状个体中肩袖撕裂的患病率较高。这些撕裂随着年龄增长越来越频繁，并且与正常、无痛的功能活动相符。本研究结果强调了在没有相关临床发现的情况下，仅将磁共振成像扫描作为确定手术干预依据的潜在风险。
