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手术前的MRI和肩部特异性测试与旋转手套撕裂的手术内发现的相关性
Emre Arikan1, Yasin E Kaya2, Metin Celik3
1Department of Orthopaedics and Traumatology, Bursa Ali Osman Sonmez Oncology Hospital, Bursa, TUR.
Cureus
|April 21, 2025
概括
手术前的MRI和肩部测试可以准确诊断全厚旋转手套撕裂 (RCT),但对于部分撕裂不那么可靠. 在手术内发现的结果往往显示出比初始成像表明的更先进的病理.
科学领域:
- 整形外科手术 整形外科手术
- 诊断成像 诊断成像 诊断成像
- 运动医学 运动医学
背景情况:
- 旋转手套撕裂 (RCT) 是肩膀疼痛和功能障碍的常见原因.
- 准确的手术前诊断对于有效的治疗计划至关重要.
- 磁共振成像 (MRI) 和临床肩部测试是标准的诊断工具.
研究的目的:
- 为了比较术前MRI和肩部测试的准确性,与进行关节镜旋转手套修复的患者的手术内发现进行比较.
- 评估特定的肩部测试和MRI在分类撕裂类型和阶段的诊断可靠性.
主要方法:
- 一项对162名接受关节镜旋转手套修复的患者的回顾性研究.
- 手术前的MRI和临床测试 (Jobe,Neer,下降臂) 与手术期间的观察结果进行了比较.
- 撕裂的类型和阶段被使用既定的分级系统 (例如,Patte,Ellman) 分类.
主要成果:
- 在手术前的MRI中,发现了77.2%的全厚和22.8%的部分旋转手套撕裂.
- 落臂试验显示了显著的差异 (p = 0.003).
- 磁力共振成像在局部试验中可靠性较低;在手术前和手术后的评估中,在两种撕裂类型之间观察到显著的等级变化 (p < 0.001 对于全厚,p = 0.018 对于部分).
结论:
- 虽然MRI是可靠的诊断旋转部撕裂,它的灵敏度是减少部分撕裂.
- 肩部测试可以在特定条件下准确,但在单独使用时可能存在局限性.
- 手术前的成像可能会低估旋转手套撕裂的严重程度,这表明手术时的病理更为先进.
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