| 摘要: |
| 目的:探究肌骨超声评估肩袖损伤患者术后冈上肌形态变化的价值,以期为临床评估术后疗效提供参考。方法:选取2022年10月～2023年7月我院95例肩袖损伤患者,均行肩关节镜下肩袖修复术治疗,分别于术前、术后6个月行肌骨超声检查冈上肌形态,获取冈上肌形态参数[冈上肌横截面积(CSA)和超声回声强度(EI)],分析肌骨超声评估冈上肌形态的可重复性,比较患者术前健侧与患侧冈上肌形态参数、不同损伤程度患者术前患侧冈上肌形态参数,并比较不同肩关节功能恢复效果患者术前、术后6个月患侧冈上肌形态参数及变化值,分析冈上肌形态参数变化值与肩关节功能恢复效果的相关性及预测肩关节功能恢复效果的价值。结果:两名超声医师评估CSA、EI的组内和组间ICC均在0.9以上(均P＜0.001),提示肌骨超声评估冈上肌形态的可重复性较强；肩袖损伤患者患侧CSA低于健侧,EI高于健侧(P＜0.05)；肩袖全层撕裂患者CSA低于肩袖部分撕裂患者,EI高于肩袖部分撕裂患者(P＜0.05)；肩关节功能恢复效果为优患者术前、术后6个月CSA高于良患者、可患者,良患者高于可患者,优患者术前、术后6个月EI低于良患者、可患者,良患者低于可患者,优患者△CSA、△EI大于良患者、可患者,良患者大于可患者(P＜0.05)；Spearman相关性分析显示,△CSA、△EI与肩关节功能恢复效果呈正相关关系(r=0.633、0.693,P＜0.05)；ROC曲线结果显示,△CSA、△EI单独预测的AUC分别为0.834、0.764,联合预测的AUC为0.922,联合预测的AUC大于△CSA、△EI单独预测的AUC(P＜0.05)。结论:肌骨超声评估肩袖损伤患者冈上肌形态变化与肩袖损伤程度及肩关节功能恢复效果密切相关,临床可通过其早期预测预后,以针对性制定相应干预方案。 |
| 关键词: 肩袖损伤 肩关节镜下肩袖修复术 肌骨超声 冈上肌形态 肩关节功能 |
| DOI： |
| 投稿时间：2024-04-11修订日期：2024-09-20 |
| 基金项目:河北省医学科学研究重点课题计划项目（编号：20210251） |
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| Value of musculoskeletal ultrasonography in assessing the morphological changes of supraspinatus muscle after rotator cuff injury |
| zhulina |
| (Tangshan Second Hospital) |
| Abstract: |
| Objective: To explore the value of musculoskeletal ultrasonography in evaluating the morphological changes of supraspinatus muscle in patients with rotator cuff injury after surgery, in order to provide reference for clinical evaluation of postoperative efficacy.Methods: A total of 95 patients with rotator cuff injury in our hospital from October 2022 to July 2023 were selected, all of which underwent shoulder arthroscopic rotator cuff repair. Musculoskeletal ultrasonography was performed before surgery and 6 months after surgery, respectively, to obtain the morphological parameters of the supraspinatus muscle [supraspinatus muscle cross-sectional area (CSA) and ultrasonic echo intensity (EI)]. The reproducibility of musculoskeletal ultrasound in assessing supraspinatus muscle morphology was analyzed, and the parameters of supraspinatus muscle morphology of healthy and affected side were compared before surgery, as well as those of patients with different injury degrees, and the parameters and changes of supraspinatus muscle morphology of patients with different shoulder joint functional recovery effects were compared before surgery and 6 months after surgery. To analyze the correlation between the morphological parameters of supraspinatus muscle and the functional recovery effect of shoulder joint and the value of predicting the functional recovery effect of shoulder joint.Results: Both the intragroup and intergroup ICC values of CSA and EI were above 0.9 (P < 0.001 for all), suggesting that musculoskeletal ultrasonography had strong repeatability in assessing supraspinatus muscle morphology. CSA on the affected side was lower than that on the healthy side, EI was higher than that on the healthy side (P < 0.05). The CSA in patients with full rotator cuff tear was lower than that in patients with partial rotator cuff tear, and EI was higher than that in patients with partial rotator cuff tear (P < 0.05). The effects of shoulder joint function recovery were as follows: CSA in excellent patients before and 6 months after surgery was higher than that in good patients and able patients; EI in excellent patients before and 6 months after surgery was lower than that in good patients and able patients; CSA and EI in excellent patients were higher than that in good patients and able patients (P < 0.05); Spearman correlation analysis showed that △CSA and △EI were positively correlated with the functional recovery of shoulder joint (r=0.633, 0.693, P < 0.05). The ROC curve results showed that the AUC of △CSA and △EI separately predicted was 0.834 and 0.764, respectively, and that of the combined forecast was 0.922, and the AUC of the combined forecast was larger than that of △CSA and △EI separately predicted (P < 0.05).Conclusion: musculoskeletal ultrasound evaluation of the morphological changes of supraspinatus muscle in patients with rotator cuff injury is closely related to the degree of rotator cuff injury and the effect of shoulder joint function recovery. |
| Key words: Rotator cuff injury Arthroscopic rotator cuff repair of shoulder Musculoskeletal ultrasound Morphology of supraspinatus muscle Shoulder joint function |
