摘要
目的探讨超声检查对类风湿性肩关节炎肩袖损伤的诊断价值。方法应用超声对47例临床拟诊肩袖损伤的类风湿性肩关节炎患者的47侧肩袖进行扫查,依次观察肩胛下肌腱、冈上肌腱、冈下肌腱、小圆肌腱在静止状态和运动状态下有无损伤及撕裂。在超声检查1周内对所有患者行肩关节镜手术治疗,将超声结果与手术结果进行对照。结果超声可清晰显示类风湿性肩关节炎肩袖病变的形态学特征,包括有无撕裂和厚度改变;共检出31侧肩袖损伤,其中不完全撕裂18侧,完全撕裂7侧,肩袖肌腱厚度变薄6侧。与关节镜手术结果比较,超声诊断肩袖损伤的总体敏感度为90.62%(29/32),特异度为86.67%(13/15),准确率为89.36%(42/47)。超声对肩袖完全撕裂的诊断准确率为100%(7/7)。结论超声对检出和判断类风湿性肩关节炎肩袖损伤程度有较高价值,尤其对显示完全撕裂和肩袖肌腱厚度变薄意义更显著。
Objective To explore the diagnostic value of ultrasonography for the rotator cuff injure of rheumatoid shoulder. Methods The rotator cuff of 47 shoulders in 47 patients clinically diagnosed as rheumatoid arthritis （RA） underwent ultrasonography, in order to observe whether there were injures in subscapular tendon, supraspinatus tendon, infrapinatus tendon and teres minor tendon during the stationary state and dynamic state. One week after ultrasonography, all patients underwent arthroscopic surgery of the shoulders. The results of ultrasonography were compared with those of arthroscopic surgery. Results The pathological characteristics of rotator cuffs in the rheumatoid shoulder could be clearly detected by ／ ultrasonography, such as tear and changes in the thickness. Rotator cuff was found in 31 of 47 shoulders, including 18 partial-thickness tear, 7 full-thickness tear （FTT） and 6 rotator cuffs thinning. Compared with arthroscopic surgery, the sensitivity of total ultrasonic diagnosis was 90. 62% （29/32）, specificity was 86.67% （13/15） and accuracy was 89.36% （42/ 47）. The diagnostic accuracy of ultrasonography for FTT was 100% （7/7）. Conclusion Ultrasonography has high diag- nostic value for detecting lesions of rotator cuff and judging damage degree in RA patients, especially for full-thinckness tear and rotator cuff thinning.
出处
《中国医学影像技术》
CSCD
北大核心
2013年第5期783-786,共4页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(30970818
81271552)
关键词
关节炎
类风湿
超声检查
肩袖
Arthritis, rheumatoid
Ultrasonography
Rotator cuff
