The Role Of MRI In The Diagnosis Of Rotator Cuff Tears And The Comparison Study Between MRI And Physical Tests

Purpose: Rotator cuff injuries are common causes of shoulder disease, the MRIexamination and shoulder special medical examination is a commonly used method for theclinical diagnosis of rotator cuff injury. In this paper, we analysis the comparison of theresults of27cases of MRI and shoulder physical examination, combined with arthroscopicfindings, and analysis its diagnostic value.Materials and Methods：Collected27patients in our hospital orthopedic routinearthroscopic examination from January2010to January2012. Inclusion criteria:(1) clinicalsymptoms of suspected rotator cuff injury;②accept arthroscopic examination or treatment;③preoperative underwent shoulder physical examination and MRI and at least one test ispositive. There are totally27patients,12male patients, average age of53.4years (41to62years); and15females, mean age55.1years (41~69years).9cases have a history oftrauma. All patients underwent preoperative a unified shoulder special physical examinationand MRI. Physical examination includs the pain at acromion/humerus greater tuberosity,drop test, painful arc, drop arm test, internal rotation muscle test, Ya Jiasen test. Which hasthe greater tuberosity tenderness and merge the rest of one or more positive signs of patientsare diagnosed as rotator cuff injury. All patients were checked by the professional orthopedicsurgeon, the shoulder physical examination results of a uniform standard record. MRI, withGE the Signal1.5T superconducting MRI machine, the patient supine,60°~120°ofshoulder abduction, put shoulder as close as possible to the center line. Shoulder axial,oblique coronal, oblique sagittal three planes FSE sequence MRI examination: obliquecoronal T1WI, T2WI; oblique coronal T2WI with fat suppression; Oblique sagittal T2WI,;axial T2WI, MRI image quality to the tendon, muscle belly shape, contour display artifactsas excellent. All image data were analyzed by two experienced radiology and if theconclusion is inconsistent we judge from the third doctor.Test according to shoulder microscope results as the standard, analysis statistics of twomethods for the diagnosis of rotator cuff injury. Use SASS package the results of Fisher’sexact chi-square test, P value less than0.05was considered statistically significant. Results：All MRI images can display the anatomical structures of the shoulder joint anddamage location. Confirmed by arthroscopy for rotator cuff injury in23cases,23cases MRIdiagnosis of a rotator cuff injury, the sensitivity was100%, specificity was75%;examination diagnosed20cases, the sensitivity was86.9%and specificity was75%.17cases confirmed by arthroscopic rotator cuff tear,11cases of full-thickness tear,5cases ofpartial tears. MRI diagnosis of tendon tear, the sensitivity was83.3%, specificity was90%,the diagnosis of partial tear with the sensitivity of80%and a specificity of80%. Drop armtendon full-thickness tear of the levy diagnostic positive rate was63.6%and a specificity of83.5%. The sensitivity of MRI and physical examination diagnosis of rotator cuff tear were94.1%,94.1%, the specificity was70%,50%. The accuracy of the two methods, according toFisher’s exact test, P=0.059>0.05, the two methods of sensitivity has no significantdifferences,and the specificity of MRI is higher than the physical examination, but with nostatistical significance.Conclusion:1Shoulder MRI is noninvasive, multi-sequence, multi-faceted advantages,with a higher accuracy of the diagnosis and classification of rotator cuff injury,which is thepreferred method for diagnosis of rotator cuff injury.2MRI diagnosis of full-thickness tearof accuracy is higher than the partial tear.3The sensitivity of MRI examination and physicalexamination diagnosis of rotator cuff tear were94.1%,94.1%, the specificity was70%,50%.Statistical analysis of the two methods is no difference in the sensitivity of the diagnosis ofrotator cuff tear, the specific has differences, but no statistical significance.4Drop-arm signfor the diagnosis of supraspinatus tendon tear had a higher diagnostic significance.5Thecause of rotator cuff injury is not only due to the impact caused by, but due to internal andexternal factors,.