河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (1): 108-112.doi: 10.3969/j.issn.1007-3205.2025.01.018

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磁共振成像在诊断肩袖损伤中的临床价值

  

  1. 河北中石油中心医院影像科，河北 廊坊 065000

  • 出版日期:2025-01-25 发布日期:2025-01-22
  • 作者简介:贺亚男（1991-），男，河北任丘人，河北中石油中心医院主治医师，医学学士，从事医学影像诊断研究。
  • 基金资助:
    廊坊市科学技术研究与发展计划（2022013021）

Clinical value of magnetic resonance imaging in the diagnosis of rotator cuff injury

  1. Department of Imaging， Hebei Petro China Central Hospital， Langfang 065000， China

  • Online:2025-01-25 Published:2025-01-22

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摘要： 目的 探讨磁共振成像（magnetic resonance imaging，MRI）在诊断肩袖损伤中的临床价值。
方法 选取疑似肩袖损伤患者120例，均给予MRI检查，分析MRI诊断肩袖损伤的价值，同时确诊的肩袖损伤患者给予非手术治疗，比较治疗有效和无效患者临床影像资料。
结果 MRI诊断肩袖损伤的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为98.04%、94.44%、97.50%、99.01%和89.47%。斜冠状位扫描冈下肌腱损伤和肩胛下肌腱损伤检出率分别为52.94%和49.02%，明显低于轴位和斜矢状位扫描（P＜0.05）；斜矢状位扫描冈上肌腱损伤检出率为77.45%，明显低于斜冠状位扫描（P＜0.05）；轴位和斜冠状位扫描小圆肌腱损伤检出率分别为7.84%和13.73%，明显低于斜矢状位扫描（P＜0.05）。治疗无效患者年龄为（65.54±7.03）岁、冈上肌回缩距离为（24.41±5.93）mm，明显高于治疗有效患者（P＜0.05）；治疗无效患者肩胛下肌撕裂程度明显重于治疗有效患者（P＜0.05），其完全撕裂比例为80.95%。Logistic回归分析显示：年龄、肩胛下肌撕裂程度是肩袖损伤患者非手术治疗效果的影响因素（P＜0.05）。构建Logistic回归模型，该模型预测治疗无效的ROC曲线下面积为0.813（95%CI：0.728~0.898，P＜0.05），敏感度和特异度分别为88.00%和64.50%。
结论 MRI在诊断肩袖损伤中有较高的敏感度和特异度，同时MRI参数-肩胛下肌撕裂程度与患者非手术治疗效果有关，值得进一步研究。


关键词: 回旋套损伤, 磁共振成像, 诊断

Abstract: Objective To explore the clinical value of magnetic resonance imaging (MRI) in the diagnosis of rotator cuff injury. 
Methods One hundred and twenty patients with suspected rotator cuff injury were selected, and all of them were given MRI examination, to analyze the value of MRI in the diagnosis of rotator cuff injury. In the meantime, patients with confirmed rotator cuff injury were given non-surgical treatment, and the difference of clinical imaging data between patients with effective and ineffective treatment were compared. 
Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI in diagnosing rotator cuff injury were 98.04%, 94.44%, 97.50%, 99.01% and 89.47%, respectively. The detection rates of infraspinatus tendon injury and subscapular tendon injury in oblique coronal scan were 52.94% and 49.02%, respectively, which were significantly lower than those in axial and oblique sagittal scan (P＜0.05). The detection rate of supraspinatus tendon injury in oblique sagittal scan was 77.45%, which was significantly lower than that in oblique coronal scan (P＜0.05). The detection rates of teres minor tendon injury in axial and oblique coronal scan were 7.84% and 13.73%, respectively, which was significantly lower than those in oblique sagittal scan (P＜0.05). The age of patients with ineffective treatment was (65.54±7.03) years, and the retraction distance of supraspinatus muscle was (24.41±5.93) mm, which were significantly higher than those in patients with effective treatment (P＜0.05). The degree of subscapular muscle tear in patients with ineffective treatment was significantly greater than that in patients with effective treatment (P＜0.05), and the complete tear ratio was 80.95%. Logistic regression analysis showed that age, and degree of subscapular muscle tear were the influencing factors of non-surgical treatment effect in patients with rotator cuff injury (P＜0.05). Logistic regression model was constructed, and the area under the ROC curve of the model in predicting ineffective treatment was 0.813 (95%CI: 0.728-0.898, P＜0.05), with sensitivity and specificity of 88.00% and 64.50%, respectively. 
Conclusion MRI has high sensitivity and specificity in the diagnosis of rotator cuff injury, and the MRI parameter, subscapular muscle tear, is related to the effect of non-surgical treatment, which is worthy of further study. 


Key words: rotator cuff injuries, magnetic resonance imaging, diagnosis

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