Chiou H J, Hsu C C, Chou Y H, Tiu C M, Jim Y F, Wu J J, Chang C Y
Department of Radiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Dec;58(6):428-34.
To evaluate the usefulness of high resolution ultrasound (HRUS) in the examination of complete rotator cuff tear (RCT).
A prospective study of 157 patients with sonographic examination of shoulder was performed. All of them complained of chronic shoulder pain and were referred by clinician for suspicion of RCT. Their age ranged from 30 to 76 years. The ultrasonic scanners we used were Acuson 128 XP 10 with 7MHz linear transducer, or Diasonics VST master series using 10MHz linear transducer. Examination positions included external rotation of shoulder for scanning biceps tendon and subscapularis tendon, and internal rotation for supraspinatus tendon and lateral scan of infraspinatus tendon and teres minor tendon. Sonographic criteria of complete RCT included 1. complete absence of rotator cuff (RC); 2. focal thinning of RC; 3. focal hypoechoic cleft of RC; 4. focal depression of RC; and 5. heterogeneous hypoechoic RC with subdeltoid bursa fluid. Arthrography was performed after sonography examination on the same day.
Among 49 complete RCTs diagnosed by sonography, 46 were proved to be complete RCT by arthrography; only 3 were false positive. In 108 patients with normal rotator cuff diagnosed by sonography, 104 had compatible results with arthrography; only 4 patients turned out to be complete RCT. The sensitivity, specificity, positive predictive values, negative predictive values and accuracy were 92%, 97.2%, 93.9%, 96.3% and 95.5%, respectively.
HRUS can directly demonstrate the morphological changes of RC. It has a high sensitivity and specificity in the diagnosis of complete RCT, and can be used as a firstline screening modality for complete RCT in patients with chronic shoulder pain.
评估高分辨率超声（HRUS）在完全性肩袖撕裂（RCT）检查中的实用性。
对157例肩部超声检查患者进行前瞻性研究。所有患者均主诉慢性肩部疼痛，因临床医生怀疑为RCT而转诊。他们的年龄在30至76岁之间。我们使用的超声扫描仪为配备7MHz线性探头的Acuson 128 XP 10或使用10MHz线性探头的Diasonics VST master系列。检查体位包括肩部外旋以扫描肱二头肌肌腱和肩胛下肌肌腱，内旋以扫描冈上肌肌腱，以及对冈下肌肌腱和小圆肌肌腱进行外侧扫描。完全性RCT的超声诊断标准包括：1. 肩袖（RC）完全缺失；2. RC局部变薄；3. RC局部低回声裂隙；4. RC局部凹陷；5. RC不均匀低回声伴三角肌下滑囊积液。在超声检查当天之后进行关节造影。
在超声诊断为49例完全性RCT中，46例经关节造影证实为完全性RCT；仅3例假阳性。在超声诊断为肩袖正常的108例患者中，104例关节造影结果与之相符；仅4例最终被证实为完全性RCT。敏感性、特异性、阳性预测值、阴性预测值和准确性分别为92%、97.2%、93.9%、96.3%和95.5%。
HRUS可直接显示RC的形态学改变。其在完全性RCT诊断中具有高敏感性和特异性，可作为慢性肩部疼痛患者完全性RCT的一线筛查方法。
