D'Erme M, De Cupis V, De Maria M, Barbiera F, Maceroni P, Lasagni M P
Istituto Chirurgico Ortopedico Traumatologico (I.C.O.T.)-Latina.
Radiol Med. 1993 Jul-Aug;86(1-2):72-80.
Shoulder pain is a common clinical problem with different etiologies. Without a specific diagnosis, treatment could be ineffective, causing functional limitation, chronic pain and atrophy. US and MRI allow in many cases to correctly define the different etiologies causing shoulder pain, often due to rotator cuff conditions. From June to September 1992, thirty patients with clinically suspected acute or chronic rotator cuff lesion were studied with US, MRI and double contrast arthrography. US and MRI findings were evaluated and compared using arthrography and surgery as the gold standard. The overall accuracy of MRI was 93%: the method yielded accurate information about size and number of rotator cuff tears, and about bursal, bone and muscle involvement. US accuracy was 83% in the diagnosis of large tears, 63% in the diagnosis of small and partial tears and only 11% in the diagnosis of tendinitis. Both MRI and arthrography exhibited high accuracy (respectively 91 and 100%) in the detection of rotator cuff tears when their results were compared with surgical findings. A flow chart to be used in the patients with acute or chronic shoulder pain was drawn from the critical analysis of the above results.
肩部疼痛是一种病因各异的常见临床问题。若未明确具体诊断，治疗可能无效，进而导致功能受限、慢性疼痛和肌肉萎缩。在许多情况下，超声（US）和磁共振成像（MRI）能够准确判定引发肩部疼痛的不同病因，这些病因通常与肩袖状况有关。1992年6月至9月，对30例临床疑似急性或慢性肩袖损伤的患者进行了超声、磁共振成像及双重对比关节造影检查。以关节造影和手术作为金标准，对超声和磁共振成像的检查结果进行评估与比较。磁共振成像的总体准确率为93%：该方法能够提供有关肩袖撕裂的大小和数量，以及滑囊、骨骼和肌肉受累情况的准确信息。超声在诊断大型撕裂时的准确率为83%，诊断小型和部分撕裂时为63%，而诊断肌腱炎时仅为11%。当将磁共振成像和关节造影的结果与手术结果相比较时，二者在检测肩袖撕裂方面均显示出较高的准确率（分别为91%和100%）。通过对上述结果的批判性分析，绘制了一份用于急性或慢性肩部疼痛患者的流程图。
