CAJ | 학술논문

目的：通过与术中肩关节镜下表现对比，探讨MRI 与三维超声对肩袖损伤(rotator cuff tears, RCT)诊断的优越性。方法2012年8月—2014年1月对46例肩袖损伤患者术前进行MRI及三维超声检查，并与其术中关节镜下表现进行对比分析，评价MRI及三维超声对肩袖损伤诊断的准确性。结果46例患者中，术前MRI检查诊断全层撕裂40例，部分撕裂6例；三维超声诊断全层撕裂37例，部分撕裂9例；术中关节镜诊断肩袖全层撕裂39例，部分撕裂7例。MRI检查对于诊断肩袖全层撕裂的敏感性是97.4%，特异性是71.4%，准确率为93.4%；三维超声对于诊断肩袖全层撕裂的敏感性是92.3%，特异性是85.7%，准确率为91.3%。三维超声与MRI检查对于冈上肌腱全层撕裂诊断的差异无显著性意义（P<0.05），但对部分撕裂诊断MRI检查特异性优于三维超声（P>0.05）。结论三维超声成像技术及MRI检查对肩袖全层撕裂的诊断均具有较高的准确率和敏感性，但对肩袖部分撕裂，MRI成像技术诊断价值优于三维超声检查。
목적：통과여술중견관절경하표현대비，탐토MRI 여삼유초성대견수손상(rotator cuff tears, RCT)진단적우월성。방법2012년8월—2014년1월대46례견수손상환자술전진행MRI급삼유초성검사，병여기술중관절경하표현진행대비분석，평개MRI급삼유초성대견수손상진단적준학성。결과46례환자중，술전MRI검사진단전층시렬40례，부분시렬6례；삼유초성진단전층시렬37례，부분시렬9례；술중관절경진단견수전층시렬39례，부분시렬7례。MRI검사대우진단견수전층시렬적민감성시97.4%，특이성시71.4%，준학솔위93.4%；삼유초성대우진단견수전층시렬적민감성시92.3%，특이성시85.7%，준학솔위91.3%。삼유초성여MRI검사대우강상기건전층시렬진단적차이무현저성의의（P<0.05），단대부분시렬진단MRI검사특이성우우삼유초성（P>0.05）。결론삼유초성성상기술급MRI검사대견수전층시렬적진단균구유교고적준학솔화민감성，단대견수부분시렬，MRI성상기술진단개치우우삼유초성검사。
Objective To evaluate the superiority of magnetic resonance imaging (MRI) and three-dimensional (3D) ultrasound in diagnosing rotator cuff tears (RCT) by comparing with the shoulder arthroscopy. Methods From August 2012 to January 2014, 46 patients with RCT used MRI and 3D ultrasound exam before operation, compared all result with each presentation of shoulder arthroscopy, in order to evaluate the accuracy of MRI and 3D ultrasound in diagnosing RCT. Results Among 46 patients, the diagnosis was 40 with full thickness RCT and 6 with partial thickness RCT by MRI; 37 patients with full thickness RCT and 9 patients with partial thickness RCT by 3D ultrasound; 39 patients with full thickness RCT and 7 patients with partial thickness RCT by shoulder arthroscopy. The sensibility, specificity and accuracy of MRI in diagnosing full thickness RCT was 97.4%, 71.4% and 93.4%;the sensibility, specificity and accuracy of 3D ultrasound was 92.3%, 85.7% and 91.3%. There was no significant difference between MRI and 3D ultrasound in diagnosing full thicknes RCT (P<0.05), but the specificity of MRI in diagnosing partial thickness RCT was better than 3D ultrasound (P <0.05). Conclusion Both 3D ultrasound and MRI has relatively high accuracy and specificity in diagnosing full thickness RCT, but MRI is better than 3D ultrasound in diagnosing partial thickness RCT.