论著-头颈部
肩关节上盂唇前后向损伤特点及MRI、MR关节造影诊断价值*1.河北省邯郸市第一医院CT室2.河北医科
作者:石俊岭1 崔建岭2 孙英彩2 孟凯龙1 程 峰3 赵志刚1 申 静4 刘永军3
所属单位:1.河北省邯郸市第一医院CT室 (河北 邯郸 056200) 2.河北医科大学第三医院CT室 (河北 邯郸 056200) 3.河北省邯郸市第一医院 (河北 邯郸 056200) 4.河北省胸科医院放射科 (河北 石家庄 050000)
PDF摘要
目的 分析MRI、MR关节造影在肩 关节上盂唇前后向损伤中的应用价值,总 结其临床特点。方法 回顾性分析自2013 年8月-2015年1月于我院经MRI及MR关节造 影检查后接受关节镜手术治疗的105例肩 部损伤患者的临床资料。由1位运动医学 医生与骨骼肌肉系统影像学医生作共同 阅片处理,将MRI及MR关节造影结果与关 节镜结果进行对照,评估MRI、MR关节造 影在肩关节盂唇前后向损伤中的诊断价 值。结果 MRI检出SLAP 28例,诊断灵敏 度、特异度、准确度为73.68%、88.24%、 83.81%;MR关节造影检出SLAP 34例,诊 断灵敏度、特异性、准确度为91.89%、 96.97%、93.33%;关节镜检出SLAP 38 例,其中Ⅰ型4例,Ⅱ型19例,Ⅲ型11 例,Ⅳ型3例,MRI分型符合率为73.68%, MR关节造影分型符合率为86.84%。结论 MR关节造影对肩关节上盂唇前后向损伤的 诊断敏感度、特异度、准确度较高,且与 肩关节镜分型符合率高。
Objective To analyze the application value of MRI and MR arthrography in superior labrum anterior and posterior (SLAP) injuries of the shoulder joint and to summarize its clinical characteristics. Methods The clinical data of 105 patients with shoulder injury who received arthroscopic surgery after MRI and MR arthrography in the hospital during August 2013 to January 2015 were retrospectively analyzed. The reading and dealing of the images were performed by both of the sports medicine doctor and a skeletal musculature imaging doctor. The results of MRI and MR arthrography were compared with the arthroscopic results. The diagnostic value of MRI and MR arthrography in superior labrum anterior and posterior lesions of the shoulder was evaluated. Results 28 cases of SLAP were detected by MRI. The sensitivity, specificity and accuracy were 73.68%, 88.24% and 83.81%, respectively. 34 cases of SLAP were detected by MR arthrography. The sensitivity, specificity and accuracy were 91.89%, 96.97% and 93.33%, respectively. 38 cases of SLAP were detected by arthroscopy. And among them, there were 4 cases of type I, 19 cases of typeⅡ, 11 cases of type III and 3 cases of type IV. The coincidence rate of MRI type was 73.68% while that of MR arthrography type was 86.84%. Conclusion The sensitivity, specificity and accuracy of MR arthrography in the diagnosis of superior labrum anterior and posterior injuries of the shoulder joint are relatively higher, and the coincidence rate with shoulder arthrography type is high
【关键词】肩关节损伤;盂唇;MRI;MR关节造影;关节镜
【中图分类号】R322.7+2R
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.03.039
前言
肩关节上盂唇前后部损伤(SLAP,Superior labral anterior to posterior)指肩关节肱二头肌长头腱在上盂唇止点从前至后的损伤类 型,多表现为肱二头肌长头腱撕裂、盂唇撕裂等[1]。多见于运动员及 老年群体,上肢用力抗阻、摔倒均为其致病原因,有肩关节功能障 碍、活动角度疼痛、短暂交锁等临床症状[2]。研究显示,SLAP损伤患 者主诉有其差异,体格检查结果并不一致,临床无特异性表现,易漏 诊及误诊[3]。鉴于此,为研究MRI及MR关节造影在SLAP临床诊断中的应 用价值,明确肩关节上盂唇前后部损伤的临床特点,对我院收治的105 例肩部损伤患者的临床资料进行了回顾性分析,现报告如下。
中国CT和MRI杂志
第14卷, 第 3 期
2016年03月
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