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MRI在常见肩关节疾病诊断中的应用 |
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朱庆生 桥本淳 信原克哉
【摘要】目的 探讨MRI对慢性肩关节疼痛的诊断和鉴别诊断的重要性。方法 本组通过70例86肩的MRI肩关节造影与手术发现结果的比较。评价肩关节造影和MRI在诊断肩袖疾患和肩关节不稳中的应用价值。结果 在诊断肩袖完全撕裂中，关节造影的敏感性为91％，特异性为100％，MRI的敏感性为95％，特异性为88％。MRI不但能够准确显示肩袖撕裂的部位。尚能显示出其它相关组织的病理改变。关节造影难以显示肩袖不全撕裂，MRI虽能显示，但缺乏敏感性。在肩关节前方不稳关节盂唇损伤的诊断中，MRI对关节盂唇异常的显示其敏感性为96％，特异性为75％。对关节盂唇撕裂的显示，其敏感性为78％，特异性为88％。结论 MRI在对引起肩关节慢性疼痛最常见的疾病即肩袖撕裂和习惯性肩关节前脱位或半脱位的诊断中能够清楚显示病变部位和相关组织的病理改变。有较高敏感性和特异性。关节造影诊断肩袖完全撕裂有较高的敏感性和特异性，且方法简单、费用较低，便于临床开展。
【关键词】磁共振 肩关节 疾病
Magnetic Resonance Imaging of Common Disorders of the Shoulder:A Comparative Study of MRI With Arthrography and Surgical Findings
ZHU Qingsheng*，Jun Hashimoto,Katsuya Nobuhara.
*Institute of Orthopaedics and Traumatology, Xijing Hospital, Fourth Military Medical University,Xi’an 710032
【Abstract】 Objective To compare the magnetic resonance imaging(MRI)with arthrography in diagnosis of the rotator cuff tears and unstable shoulder. Methods 86 shoulders in 70 patients were examined by MRI and arthrography and compared with the surgical findings.Results The sensitivity of demonstrating the rotator cuff complete tear was 95％ by MRI and 91％ by arthrography, the specificity was 88％ in MRI and 100％ in arthrography. The sensitivity and specificity of MRI were 96％ and 75％ for detecting the glenolabrum abnormalities, and 78％and 88％for detecting the labrum tear in 37 cases with 40 shoulders associated with unstable shoulder. Differentiating the severe tendinitis, incomplete tear and small complete tear was difficulty in MR imaging. The morphological changes of labrum were more valuable than the isolate increased signal in labral substance in diagnosis of the labrum tear. Conclusion This study showed that the MR imaging not only kept the high sensitivity in demonstrating the abnormalities of rotator cuff and glenolabrum, but also displayed the pathologic changes of these structures and the related bone and soft tissues.
【Key words】 Magnetic reso[1] [2] 下一页
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