高频超声鉴别诊断部分及全层小撕裂型肩袖损伤的价值探讨

摘要/Abstract

摘要： 目的探讨与分析高频超声鉴别诊断部分及全层小撕裂型肩袖损伤的价值。方法选取2020年10月~2022年1月新疆生产建设兵团第六师医院收治的70例部分及全层小撕裂型肩袖损伤患者作为研究对象,所有患者都给予关节镜检查（金标准）与高频超声检查,记录影像学特征并判断诊断价值。结果在70例患者中,关节镜诊断为部分小撕裂型肩袖损伤50例（部分组）,全层小撕裂型肩袖损伤20例（全层组）。两组的损伤部位、损伤到超声时间、体质量指数、性别、年龄等对比,差异无统计学意义（P>0.05）。全层组的腱鞘积液、肩袖钙化、肌腱变性、肌腱增厚等超声特征占比均明显高于部分组,差异有统计学意义（P<0.05）。全层组的肌筋膜厚度、冈下肌腱厚度、冈上肌腱厚度都显著高于全层组,差异有统计学意义（P<0.05）。在70例患者中,高频超声诊断为全层小撕裂型肩袖损伤19例,部分小撕裂型肩袖损伤51例,高频超声鉴别诊断部分及全层小撕裂型肩袖损伤的敏感性与特异性分别为90.00%（18/20）和98.00%（49/50）,Kappa值为0.893。ROC曲线显示高频超声鉴别诊断部分及全层小撕裂型肩袖损伤的曲线下面积为0.914。结论全层小撕裂型肩袖损伤在超声上主要表现为腱鞘积液、肩袖钙化、肌腱变性、肌腱增厚,尤其是可导致肌筋膜厚度、冈下肌腱厚度、冈上肌腱厚度增加,高频超声鉴别诊断部分及全层小撕裂型肩袖损伤具有很高的敏感性与特异性,与关节镜检查诊断具有高度一致性。

关键词: 全层小撕裂型肩袖损伤, 高频超声, 腱鞘积液, 肩袖钙化, 肌腱变性, 肌腱增厚

Abstract: Objective To explore and analysis the values of high-frequency ultrasound in the differential diagnosis of partial and full-thickness small tear rotator cuff injuries. Methods From October 2020 to January 2022, 70 cases of patients with partial and full-thickness small tear rotator cuff injuries who were diagnosed and treated in The Sixth Division Hospital of Xinjiang Production and Construction Corps were selected as the research subjects. All patients were given arthroscopy and high-frequency ultrasonography, the images characteristics were recorded and determined the diagnostic values. Results In the 70 patients, there were 50 cases of partial small tear rotator cuff injury (partial group) and 20 cases of full-thickness small tear rotator cuff injury (full-thickness group) were diagnosed by arthroscopy. There was no significant difference compared between the two groups in terms of injury site, time from injury to ultrasound, body mass index, gender, and age (P>0.05). In the full-thickness group, the proportions of ultrasonographic features such as hydrocele, rotator cuff calcification, tendon degeneration, and tendon thickening were significantly higher than the partial group(P<0.05). The myofascial thickness, infraspinatus tendon thickness and supraspinatus tendon thickness in the full-thickness group were significantly higher than those in the full-thickness group, the difference is statistically significant (P<0.05). In the 70 patients, there were 19 cases were diagnosed as full-thickness small tear rotator cuff injury by high frequency ultrasound, and 51 cases were partial small tear type rotator cuff injury. The sensitivity and specificity of high-frequency ultrasonography in the differential diagnosis of partial and full-thickness small tear rotator cuff injuries were 90.0% (18/20) and 98.0% (49/50), respectively, Kappa value is 0.893. The ROC curve showed that the area under the curve of high-frequency ultrasound for differential diagnosis of partial and full-thickness small tear rotator cuff injuries was 0.914. Conclusion Full-thickness small tear rotator cuff injuries are mainly manifested by hydrocele, rotator cuff calcification, tendon degeneration, and tendon thickening on ultrasound, especially the thickness of myofascial, infraspinatus and supraspinatus tendons. In addition, high-frequency ultrasonography has high sensitivity and specificity in the differential diagnosis of partial and full-thickness small tear rotator cuff injuries, with a high degree of concordance with the diagnosis of arthroscopy.

Key words: full-thickness small tear rotator cuff injury, high-frequency ultrasound, hydrocele, rotator cuff calcification, tendon degeneration, tendon thickening

中图分类号:

R445.1

谢泽玮. 高频超声鉴别诊断部分及全层小撕裂型肩袖损伤的价值探讨[J]. 中华养生保健, 2022, 40(23): 168-171.

XIE Ze-wei. The Values of High-frequency Ultrasonography in Differential Diagnosis of Partial and Full-thickness Small Tear Rotator Cuff Injuries[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(23): 168-171.

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