3.0T MRI平扫与64排螺旋CT在诊断肩关节损伤中的对比研究

Comparative study of 3.0T MRI and 64-slice spiral CT in the diagnosis of shoulder joint injuries

摘要:

目的 分析3.0T MRI平扫与64排螺旋CT在诊断肩关节损伤中的应用效果。方法 选取2023年11月—2024年12月在中国人民解放军联勤保障部队第九〇三医院就诊的疑似肩关节损伤患者122例，以关节镜检查为“金标准”，分析肩关节损伤患者的诊断结果。对其采取3.0T MRI平扫、64排螺旋CT检查，比较3.0T MRI平扫、64排螺旋CT检查肩关节损伤的诊断效能及对肩关节损伤不同情况的诊断准确率。结果 122例疑似肩关节损伤患者中，以关节镜检查为“金标准”，确诊肩关节损伤116例（95.08%），其中肩袖损伤76例，盂唇损伤32例，肩峰撞击综合征13例，粘连性肩关节囊炎4例，肱二头肌长头腱损伤2例。3.0T MRI平扫诊断肩关节损伤的敏感性为84.48%（95% CI：0.759，0.930），特异性为66.67%（95% CI：0.582，0.752）；64层螺旋CT诊断肩关节损伤的敏感性为59.48%（95% CI：0.510，0.680），特异性为33.33%（95% CI：0.248，0.418）。3.0T MRI平扫检查肩袖损伤、盂唇损伤诊断准确率均高于64排螺旋CT检查（P <0.05）；3.0T MRI平扫与64排螺旋CT检查肩峰撞击综合征、粘连性肩关节囊炎和肱二头肌长头腱损伤诊断准确率比较，差异均无统计学意义（P >0.05）。3.0T MRI平扫诊断肩袖损伤的敏感性为53.95%（95% CI：0.455，0.625），特异性为76.09%（95% CI：0.676，0.846）；64层螺旋CT诊断肩袖损伤的敏感性为26.32%（95% CI：0.178，0.348），特异性为86.96%（95% CI：0.785，0.955）。3.0T MRI平扫诊断盂唇损伤的敏感性为53.95%（95% CI：0.455，0.625），特异性为76.09%（95% CI：0.676，0.846）；64层螺旋CT诊断盂唇损伤的敏感性为26.32%（95% CI：0.178，0.348），特异性为86.96%（95% CI：0.785，0.955）。结论 肩关节损伤患者应用3.0T MRI平扫、64排螺旋CT检查均具有较好的诊断效能，但3.0T MRI平扫检查在诊断肩关节损伤方面更具优势。

Abstract:

Objective To analyze the application effects of 3.0T magnetic resonance imaging (MRI) and 64-slice spiral computed tomography (CT) in the diagnosis of shoulder joint injuries.Methods A total of 122 patients with suspected shoulder joint injuries who visited the 903rd Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from November 2023 to December 2024 were selected. The findings of arthroscopy were taken as the gold standard to analyze the diagnostic results of patients with suspected shoulder joint injuries. The 3.0T MRI and 64-slice spiral CT scans were performed on all the patients. The diagnostic efficacy of 3.0T MRI and 64-slice spiral CT scans for shoulder joint injuries and their diagnostic accuracy for different conditions of shoulder joint injuries were compared.Results Among 122 patients with suspected shoulder joint injuries, arthroscopy was used as the gold standard, confirming shoulder joint injuries in 116 cases (95.08%). The specific diagnoses included 76 cases of rotator cuff injuries, 32 cases of labral injuries, 13 cases of subacromial impingement syndrome, 4 cases of adhesive capsulitis, and 2 cases of long head of the biceps tendon injuries. The sensitivity of 3.0T MRI in diagnosing shoulder joint injuries was 84.48% (95% CI: 0.759,0.930), with a specificity of 66.67% (95% CI: 0.582, 0.752). The sensitivity of 64-slice spiral CT in diagnosing shoulder joint injuries was 59.48% (95% CI: 0.510,0.680), with a specificity of 33.33% (95% CI: 0.248, 0.418). The diagnostic accuracy of 3.0T MRI for rotator cuff and labral injuries was higher than that of 64-slice spiral CT (P < 0.05). The diagnostic accuracy of 3.0T MRI and 64-slice spiral CT for subacromial impingement syndrome, adhesive capsulitis, and long head of the biceps tendon injuries showed no significant differences (P > 0.05). The sensitivity of 3.0T MRI in diagnosing rotator cuff injuries was 53.95% (95% CI: 0.455, 0.625), with a specificity of 76.09% (95% CI: 0.676, 0.846). The sensitivity of 64-slice spiral CT in diagnosing rotator cuff injuries was 26.32% (95% CI: 0.178, 0.348), with a specificity of 86.96% (95% CI: 0.785, 0.955). The sensitivity of 3.0T MRI in diagnosing of labral injuries was 53.95% (95% CI: 0.455, 0.625), with a specificity of 76.09% (95% CI: 0.676, 0.846). The sensitivity of 64-slice spiral CT in diagnosing labral injuries was 26.32% (95% CI: 0.178, 0.348), with a specificity of 86.96% (95% CI: 0.785, 0.955).Conclusion Both 3.0T MRI and 64-slice spiral CT demonstrate good diagnostic performance for shoulder joint injuries, but 3.0T MRI shows a superior advantage in detecting such injuries.