肖利华 高云 蔡庆文 张坤林 邹玉坚 吴凤英

【摘要】 目的：研究分析肩袖损伤应用MR肩关节造影诊断的价值。方法：参与本试验的肩袖损伤患者共30例，将MR肩关节造影和传统常规MRI两种方法分别应用于所有患者病症检查诊断中。同时所有患者又均接受关节镜检查，将其检查结果作为试验结果讨论比较的金标准。所有患者应用不同方法检查诊断准确率以金标准为参考进行比较，确定其诊断价值。结果：以关节镜诊断结果为金标准，MR肩关节造影肩袖变性诊断准确率、肩袖全层撕裂诊断准确率、肩袖撕裂并发盂唇损伤诊断准确率及肩袖部分撕裂诊断准确率明显高于传统常规MRI检查，组间比较差异均有统计学意义（P<0.05）。结论：在肩袖损伤病症患者的临床诊断中，将MR肩关节造影方法应用其中诊断效果更好，同时该诊断方法操作简单、安全性高，能够有效提高病症诊断准确率，临床应用价值明显。

【关键词】 肩袖损伤； MRI診断； MR肩关节造影； 诊断价值

【Abstract】 Objective：To investigate the value of MR arthrography in the diagnosis of rotator cuff injuries.Method：30 cases of rotator cuff injury were involved in this study.The MR shoulder arthrography and traditional conventional MRI methods were applied to all patients diagnosis and diagnosis respectively.At the same time，all patients were treated with arthroscopy，the test results as the experimental results to discuss the comparison of gold standards.Two groups of patients used different methods to check the diagnostic accuracy to gold standard for reference to determine the diagnostic value.Result：The results of arthroscopic diagnosis were gold standard，the test results show that compared to the control group，rotator cuff degeneration diagnosis rate， accuracy rate， full-thickness rotator cuff tear diagnosis of rotator cuff tear with labrum injury diagnosis accuracy and the accuracy rate of diagnosis of rotator cuff tear were higher than those in the conventional MRI examination，the difference was statistically significant（P<0.05）.Conclusion：In the clinical diagnosis of patients with rotator cuff injury，the MR shoulder arthroplasty method is more effective in the diagnosis，and the diagnosis method is simple and safe， which can effectively improve the diagnostic accuracy of the disease and the clinical application value is obvious.

【Key words】 Rotator cuff injury； MRI diagnosis； MR shoulder joint angiography； Diagnostic value

First-authors address：Dongguan Peoples Hospital，Dongguan 523059，China

doi：10.3969/j.issn.1674-4985.2018.04.032

根据临床统计指标数据发现，我国每年患有肩袖损伤的患者均占有一定比重[1]，该病症属于临床常见病及高发病之一[2]。肩袖损伤病症发病趋势越来越年轻化[3]，对患者身体健康及正常生活均会造成较大影响。肩袖损伤患者多会表现出明显肩关节疼痛、肩关节不稳情况[4]，经临床实践发现该病症发病原因很多，其中比较常见的即为肩关节反复性创伤及肌腱改变等[5]。肩袖损伤病症临床治疗复杂[6]，其关键环节即为病症诊断[7]，容易出现漏诊或者误诊情况，很多医护人员将肩袖损伤病症诊断为肩周炎等，误诊容易耽误临床治疗，影响临床治疗效果。目前，临床医学多将MR肩关节造影方法应用于肩袖损伤病症临床诊断中，不同病症损伤类型诊断准确率均较高，诊断价值突出，现报道如下。……