经皮超声引导肩峰下滑囊造影诊断肩袖撕裂的价值。

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2023-03-30 DOI:10.11152/mu-3913

Ruochen Li, Miao Li, Yipeng Cui, Pei Yang, Chen Zhang

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With the results of shoulder arthroscopy serving as the standard, PUSB results were compared with MRI and US results using the X2 -test (a=0.05, two-sided).Results In all 78 patients, the overall accuracy of MRI, US, and PUSB in diagnosing rotator cuff tears was 82.1% (64/78), 75.6% (59/78) and 96.2% (75/78), respectively (P < 0.001). Among 21 patients with full-thickness tears, the numbers of cases correctly diagnosed by MRI, US and PUSB were 19, 19 and 21, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing full-thickness tears were 90.5%, 90.5%, 100% and 98.2%, 93.0%, 100%, respectively. The diagnostic accuracies of full-thickness rotator cuff tears were 90.5%, 90.5% and 100%, respectively, with no statistical difference (P = 0.344). Among 42 patients with partial-thickness tears, the numbers of patients whose cases were correctly diagnosed on MRI, US and PUSB were 32, 27 and 40, respectively. 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引用次数: 0

摘要

摘要目的探讨经皮超声引导下肩峰下滑囊造影(PUSB)诊断肩袖撕裂的可行性及诊断价值。方法选择2019年7月至2021年10月西安交通大学附属第二医院收治的疑似肩袖损伤患者78例，其中男性32例，女性46例，年龄31 ~ 70岁，平均年龄53.9±9.1岁，病程1 ~ 2年。回顾性分析患者的MRI、US、PUSB影像，获得三种方法对不同类型肩袖撕裂(全层撕裂、部分撕裂、无撕裂)的诊断和预测指标(敏感性、特异性、阳性预测值、阴性预测值、准确性)。以肩关节镜检查结果为标准，将PUSB结果与MRI、US结果进行X2检验(a=0.05，双侧)。结果78例患者中，MRI、US和PUSB诊断肩袖撕裂的总体准确率分别为82.1%(64/78)、75.6%(59/78)和96.2% (75/78)(P < 0.001)。21例全层撕裂患者中，MRI、US、PUSB正确诊断的分别为19例、19例、21例。MRI、US、PUSB诊断全层撕裂的敏感性、特异性分别为90.5%、90.5%、100%和98.2%、93.0%、100%。全层肩袖撕裂的诊断准确率分别为90.5%、90.5%和100%，差异无统计学意义(P = 0.344)。在42例部分厚度撕裂患者中，MRI、US和PUSB正确诊断的病例分别为32例、27例和40例。MRI、US、PUSB诊断部分厚度撕裂的敏感性、特异性分别为76.2%、64.3%、95.2%、88.9%、88.9%、97.2%。部分厚度肩袖撕裂的诊断准确率分别为76.2%(32/42)、64.3%(27/42)和95.2%(40/42)，差异有统计学意义(P<0.05)。15例无撕裂的患者中，MRI、US、PUSB的误诊例数分别为2例、2例、1例，均被误诊为部分厚度撕裂。MRI、US、PUSB诊断完全性肩袖的敏感性、特异性分别为86.7%、86.7%、93.3%、85.7%、82.5%、96.8%，诊断无撕裂的准确率分别为86.7%(13/15)、86.7%(13/15)、87.5% (14/15)(P = 0.997)。结论PUSB诊断肩袖撕裂是可行的，可作为评价肩袖撕裂的重要补充影像学方法。

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The value of percutaneous ultrasound-guided subacromial bursography in the diagnosis of rotator cuff tears.

AbstractPurpose To determine the feasibility and diagnostic value of percutaneous ultrasound-guided subacromial bursography (PUSB) in the diagnosis of rotator cuff tears.Methods Between July 2019 to October 2021, 78 patients who had suspected rotator cuff injury and who were admitted to the Second Affiliated Hospital of Xi'an Jiaotong University were selected, including 32 males and 46 females, aged 31-70 years (mean age 53.9±9.1 years), with a course of 1D-2 years. The MRI, US and PUSB images of patients were retrospectively analyzed to obtain the diagnostic and predictive indexes (sensitivity, specificity, positive predictive value，negative predictive value and accuracy) of these three methods for different rotator cuff tears types (full-thickness tears, partial-thickness tears and no tears of rotator cuff ). With the results of shoulder arthroscopy serving as the standard, PUSB results were compared with MRI and US results using the X2 -test (a=0.05, two-sided).Results In all 78 patients, the overall accuracy of MRI, US, and PUSB in diagnosing rotator cuff tears was 82.1% (64/78), 75.6% (59/78) and 96.2% (75/78), respectively (P < 0.001). Among 21 patients with full-thickness tears, the numbers of cases correctly diagnosed by MRI, US and PUSB were 19, 19 and 21, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing full-thickness tears were 90.5%, 90.5%, 100% and 98.2%, 93.0%, 100%, respectively. The diagnostic accuracies of full-thickness rotator cuff tears were 90.5%, 90.5% and 100%, respectively, with no statistical difference (P = 0.344). Among 42 patients with partial-thickness tears, the numbers of patients whose cases were correctly diagnosed on MRI, US and PUSB were 32, 27 and 40, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing partial-thickness tears were 76.2%, 64.3%, and 95.2% and 88.9%, 88.9%, and 97.2%, respectively. The diagnostic accuracies of partial-thickness rotator cuff tears were 76.2% (32/42), 64.3% (27/42) and 95.2% (40/42), respectively (P＜0.05). Among the 15 patients without tears, the numbers of misdiagnosed cases by MRI, US and PUSB were 2, 2, and 1, respectively, and they were all misdiagnosed as partial-thickness tears. The sensitivity and specificity of MRI, US and PUSB in the diagnosis of complete rotator cuff were 86.7%, 86.7%, and 93.3% and 85.7%, 82.5% and 96.8%, respectively, and the accuracies in diagnosing no tears were 86.7% (13/15), 86.7% (13/15) and 87.5% (14/15), respectively (P = 0.997).Conclusions It is feasible to diagnose rotator cuff tears by PUSB, which can be used as an important supplement imaging method to evaluate rotator cuff tears.

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.