摘要
[目的]对比术前MRI测量与术中所见,探讨MRI诊断冈上肌腱全层撕裂的价值。[方法]回顾性分析2017年1月—2023年12月冈上肌腱全层撕裂41例患者的临床资料。根据术中镜下测量撕裂长度分重度组(长度≥3 cm)与轻中度组(长度<3 cm)。比较两组术前MRI和术中指标。对组间差异有统计学意义的MRI评估指标行ROC分析。[结果]依据术中肩袖撕裂程度所见将患者分为重度组14例,轻中度组27例。重度组的术中测量撕裂长度[(40.0±7.8) mm vs(17.9±4.2) mm, P<0.001]、冠状面肌腱撕裂长度(coronal length, CL)[(13.6±5) mm vs(6.2±3.1) mm, P<0.001]、水平面肌腱撕裂长度(horizontal length, HL)[(16.1±5.5) mm vs(9.0±2.3) mm, P<0.001]、肌腱撕裂校正长度(combined length, CoL)[(21.8±5.3) mm vs(11.1±3.1) mm, P<0.001]、肩峰下积液厚度(subacromial thickness of fluid accumulation, STFA)[(4.1±2.1) mm vs(2.7±1.7) mm, P=0.033]均显著大于轻中度组。但是,两组在肩关节前方和内侧积液发生率、肩峰肱骨间距(acromiohumeral interval distance, AHID)、横断面喙肱距离(coracohumeral dis-tance, CHD横断)的差异均无统计学意义(P>0.05)。ROC分析表明,MRI测得冈上肌腱CoL、CL、HL和STFA预测术中测量撕裂大小的曲线下面积(area under curve, AUC)分别为0.950、0.878、0.865、0.694。[结论]综合两个或两个以上MRI测量指标可以准确评估冈上肌腱全层撕裂的严重程度,校正撕裂长度的诊断效能最高。
[Objective]To evaluate the value of MRI in diagnosis of supraspinatus tendon tear by comparing preoperative MRI measurements with intraoperative findings.[Methods]A retrospective study was done on 41 patients who had total supraspinatus tendon tear treated surgically from January 2017 to December 2023.Based on the intraoperative tear length,the patients were divided into the severe group with tear length≥3 cm,and mild to moderate group with tear length<3 cm.The preoperative MRI and intraoperative findings were compared between the two groups.ROC analysis was performed for MRI predicating severity of tendon tear using the parameters statistically significant between the two groups.[Results]According to the extent of rotator cuff tear found during operation,14 patients fall into the severe group,while the remaining 27 paitents were in the mild to moderate group.The severe group proved significantly greater than the mild to moderate group in terms of tear length intraoperatively measured[(40.0±7.8)mm vs(17.9±4.2)mm,P 0.001],as well as preoperative MRI measurments,including coronal length(CL)of tendon tear[(13.6±5)mm vs(6,6.2±3.1)mm,P 0.001],horizontal length(HL)of tendon tear[(16.1±5.5)mm vs(9.0±2.3)mm,P 0.001],combined length(CoL)of tendon tear[(21.8±5.3)mm vs(11.1±3.1)mm,P 0.001],and the subacromial thickness of fluid accumulation(STFA)[(4.1±2.1)mm vs(2.7±1.7)mm,P 0.033].However,there were no significant difference in the incidence of anteromedial glenohumeral effusion,acromiohumeral interval distance(AHID),and coracohumeral distance(CHD)between the two groups(P>0.05).As results of ROC analysis,the area under curve(AUC)of CoL,CL,HL and STFA measured by preoperative MRI in predicting intraoperative tear extent was 0.950,0.878,0.865 and 0.694,respectively.[Conclusion]Combining two or more MRI measurements can accurately predict the severity of supraspinatus tendon tears,and the diagnostic efficacy of the combined length measured in preoperative MRI is the highest.
作者
孙海涛
冯银波
詹德平
储伟
王为苗
唐鹏
储旭东
许斌
SUN Hai-tao;FENG Yin-bo;ZHAN De-ping;CHU Wei;WANG Wei-miao;TANG Peng;CHU Xu-dong;XU Bin(Department of Orthopedics,Wuxi Huishan District People's Hospital,Xinglin College,Nantong University,Wuxi 214000,China;Department of Radiology,Lihu Street Community Health Service Center,Wuxi 214000,China)
出处
《中国矫形外科杂志》
北大核心
2025年第9期856-860,共5页
Orthopedic Journal of China
基金
江苏省卫健委科研基金项目(编号:Z2022059)
江苏省医院协会医院管理创新研究课题(编号:JSYGY-3-2024-16)
无锡市卫生健康委员会中青年拔尖人才支持计划(编号:HB2023121)
无锡市中医药管理局科技项目(编号:ZYYB03)。
