摘要
目的 探讨肌骨超声诊断肩袖损伤的效能,并分析与关节镜手术结果的一致性。方法 选取2021年10月—2023年6月收治的162例疑似肩袖损伤患者,均接受关节镜手术治疗,得出明确手术结果,术前接受肌骨超声检查,比较肌骨超声与关节镜手术诊断肩袖损伤效能,分析肌骨超声与关节镜手术诊断肩袖损伤位置、撕裂程度的一致性,比较肩袖损伤与非肩袖损伤患者肌骨超声诊断情况。结果 肌骨超声检查诊断肩袖损伤的敏感度为98.04%(150/153),特异度为88.89%(8/9),漏诊率为1.96%(3/153),误诊率为11.11%(1/9),阳性预测值为98.68%(150/152),阴性预测值为72.73%(8/11),准确率为97.53%(158/162)。肌骨超声与关节镜手术对肩袖损伤位置诊断一致性的Kappa值为0.945(95%CI:0.840,1.050)(P<0.05),符合率为97.39%。肌骨超声与关节镜手术对肩袖损伤撕裂程度诊断一致性的Kappa值为0.916(95%CI:0.758,1.075)(P<0.01),符合率为96.08%。肩袖损伤患者腱体内低回声、腱体滑囊面凹陷发生率高于非肩袖损伤患者,肱二头肌长头肌腱鞘积液深度、肩峰下滑囊积液深度大于非肩袖损伤患者(P<0.05,P<0.01)。结论 肌骨超声用于肩袖损伤诊断有较高效能,与关节镜手术结果一致性较高,术前明确诊断可为后续关节镜等治疗提供参考。
Objective To investigate the efficiency of musculoskeletal ultrasound in the diagnosis of rotator cuff injury and to analyze the consistency of the results with arthroscopic surgery.Methods A total of 162 patients with suspected rotator cuff injury from October 2021 to June 2023 were selected,all of whom were treated with arthroscopic surgery,and the results were obtained.Before surgery,musculoskeletal ultrasound was performed to compare the efficiency of musculoskeletal ultrasound and arthroscopic surgery in diagnosing rotator cuff injury,and the consistency of musculoskeletal ultrasound and arthroscopic surgery in diagnosing location and tear degree of rotator cuff injury was analyzed.Comparison of musculoskeletal ultrasound in patients with rotator cuff injury and non-rotator cuff injury was performed.Results The sensitivity of musculoskeletal ultrasound in diagnosing rotator cuff injury was 98.04%(150/153),and specificity was 88.89%(8/9),with missed diagnosis rate of 1.96%(3/153),misdiagnosis rate of 11.11%(1/9),positive predictive value of 98.68%(150/152),negative predictive value of 72.73%(8/11),and accuracy of 97.53%(158/162).The Kappa value of consistency between musculoskeletal ultrasound and arthroscopic surgery in the diagnosis of rotator cuff injury was 0.945(95%CI:0.840,1.050)(P<0.05),and the coincidence rate was 97.39%.The Kappa value of consistency between musculoskeletal ultrasound and arthroscopic surgery in diagnosis of rotator cuff injury and tear degree was 0.916(95%CI:0.758,1.075)(P<0.01),and the coincidence rate was 96.08%.In patients with rotator cuff injury,the depth of intratendon hypoecho and bursa depression were higher than those without rotator cuff injury,and the depth of fluid accumulation in biceps long head tendon sheath and acromial bursa was higher than that of patients without rotator cuff injury(P<0.05,P<0.01).Conclusion Musculoskeletal ultrasound has high efficiency in the diagnosis of rotator cuff injury and is consistent with the results of arthroscopic surgery.The preoperative diagnosis can provide reference for the follow-up treatment such as arthroscopy.
作者
朱亚玲
袁松
宋建琼
胡方源
ZHU Yaling;YUAN Song;SONG Jianqiong;HU Fangyuan(Department of Ultrasound Medicine,Dazhou Central Hospital,Dazhou,Sichuan 635000,China;Department of Orthopaedics,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)
出处
《临床误诊误治》
CAS
2024年第3期104-108,共5页
Clinical Misdiagnosis & Mistherapy
基金
达州市科学技术和知识产权局科技计划项目(2018JY0324)。
关键词
肩袖损伤
肌骨超声
关节镜
诊断效能
一致性
KAPPA值
Rotator cuff injury
Musculoskeletal ultrasound
Arthroscope
Diagnostic efficiency
Consistency
Kappa value
作者简介
朱亚玲,本科,主治医师。主要从事肌骨超声方向研究;通讯作者:袁松,E-mail:zhuyaling993@126.com。
