超声检查在冈上肌腱损伤诊断治疗与随访中的应用价值-华西医学.pdf

• 56 • West China Medical Journal, Jan. 2017, Vol. 32, No.1 ·论 著· 超声检查在冈上肌腱损伤诊断、治疗 与随访中的应用价值 肖静 广元市第一人民医院超声科（四川广元  628017 ） 【摘要】   目的    探讨超声检查在冈上肌腱损伤的诊断、治疗与随访中的应用价值。方法    对广元市第一人 民医院 2014 年 5 月—2015 年 10 月间临床体格检查疑似冈上肌腱损伤的 52 例患者进行超声及 MRI 检查，根据病 情行保守或手术治疗，结果与 MRI 及关节镜手术对照，并在后续不同恢复阶段行超声连续随访，观察冈上肌腱变 化情况，为临床下一步治疗提供依据。结果    经超声诊断为冈上肌腱损伤 37 例，以 MRI 结果为参照，超声检查 发现冈上肌腱损伤的灵敏度为 85.0% ，特异度为 75.0% ，阳性似然比为 91.9% ，阴性似然比为 60.0% ，符合率为 82.7%。37 例患者中 18 例行保守治疗，7 例行超声引导下针刺冈上肌腱钙化物捣碎及抽吸治疗，12 例行关节镜手 术。结论    超声诊断冈上肌腱病变，准确性较高，可实现双侧对比，实时获取患者动态信息，必要时可引导局部 病灶的定位、穿刺等，且费用较低，便于治疗随访。 【关键词】  超声；冈上肌腱；诊断；治疗；随访 Clinical value of ultrasound in diagnosing, treating and follow-up of patients with supraspinatus tendon injury XIAO Jing Department of Ultrasound, the First People’s Hospital of Guangyuan, Guangyuan, Sichuan 628017, P. R. China Corresponding author: XIAO Jing, Email:163.com 【Abstract 】 Objective    To investigate the value of ultrasound in diagnosing, treating and follow-up of patients with supraspinatus tendon injury. Methods    Between May 2014 and October 2015, ultrasound and MRI examinations were performed on 52 patients who were suspected to have supraspinatus tendon injury in the First People’s Hospital of Guangyuan. According to the conditions of the disease, patients underwent conservative or surgical treatment. The treatment results were compared with MRI and arthroscopic surgery. And regular ultrasound follow-up was performed at different recovery stages to observe the changes of the supraspinatus tendon, in order to provide corresponding basis for further clinical treatment. Results    Ultrasound results showed that 37 patients had supraspinatus tendon injury. Based on MRI results, the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and coincidence rate of the ultrasound examination were 85.0%, 75.0%, 91.9%, 60.0% and 82.7%