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首页> 外文期刊>Open access Journal of Sports Medicine >Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI
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Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI

机译：使用标准的非增强型肩部MRI诊断二头肌近端肌腱撕裂的诊断准确性

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Background: There is a paucity of data in the literature evaluating the performance of noncontrast MRI in the diagnosis of partial and complete tears of the proximal portion of the long head of the biceps (LHB) tendon. The objective of this study was to evaluate the accuracy of noncontrast magnetic resonance imaging (MRI) compared to arthroscopy for the diagnosis of pathology involving the intra-articular portion of the LHB tendon.Methods: We conducted a retrospective review of 66 patients (mean age 57.8 years, range 43–70 years) who underwent shoulder arthroscopy and evaluation of the LHB tendon after having had a noncontrast MRI of the shoulder. Biceps pathology was classified by both MRI and direct arthroscopic visualization as either normal, partial tearing, or complete rupture, and arthroscopy was considered to be the gold standard. We then determined the sensitivity, specificity, and positive- and negative-predictive values of MRI for the detection of partial and complete LHB tears.Results: MRI identified 29/66 (43.9%) of patients as having a pathologic lesion of the LHB tendon (19 partial and ten complete tears) while diagnostic arthroscopy identified tears in 59/66 patients (89.4%; 50 partial and 16 complete). The sensitivity and specificity of MRI for detecting partial tearing of the LHB were 27.7% and 84.2%, respectively (positive predictive value =81.2%, negative predictive value =32.0%). The sensitivity and specificity of MRI for complete tears of the LHB were 56.3% and 98.0%, respectively (positive predictive value =90.0%, negative predictive value =87.5%).Conclusion: Standard noncontrast MRI of the shoulder is limited in detecting partial tears and complete ruptures of the intra-articular LHB tendon. Surgeons may encounter pathologic lesions of the LHB tendon during arthroscopy that are not visualized on preoperative MRI.
机译：背景：文献中缺乏数据评估无对比度MRI在诊断二头肌（LHB）肌腱长头近端部分和完全撕裂中的性能。这项研究的目的是评估非造影磁共振成像（MRI）与关节镜检查相比的准确性，以诊断涉及LHB肌腱关节内部分的病理。方法：我们对66例患者（平均年龄）进行了回顾性审查。 57.8岁，范围43-70岁）在接受了肩部MRI对比检查后接受了肩关节镜检查和LHB肌腱评估。通过MRI和直接关节镜检查将二头肌病理分为正常，部分撕裂或完全破裂，关节镜检查被认为是金标准。然后我们确定了MRI对LHB局部和完全撕裂的敏感性，特异性以及阳性和阴性预测值。结果：MRI确定29/66（43.9％）患者患有LHB肌腱病理病变（19次局部泪液和10次完全泪液），而诊断性关节镜检查在59/66位患者中发现了眼泪（89.4％; 50次局部泪液和16次完全泪液）。 MRI检测LHB部分撕裂的敏感性和特异性分别为27.7％和84.2％（阳性预测值= 81.2％，阴性预测值= 32.0％）。 MRI对LHB完全撕裂的敏感性和特异性分别为56.3％和98.0％（阳性预测值= 90.0％，阴性预测值= 87.5％）。结论：肩部标准非造影MRI在检测部分泪液方面存在局限性和关节内LHB肌腱完全破裂。外科医生可能在关节镜检查中遇到LHB肌腱的病理性病变，而术前MRI上看不到。

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