ROTATOR MANŞET YIRTIKLARINDA BİSEPS TENDON PATOLOJİLERİNİN SAPTANMASINDA PREOPERATİF MR’IN ETKİNLİĞİ: MR VE İNTRAOPERATİF BULGULARIN KORELASYONU

Year 2022, , 85 - 91, 01.03.2022

Ahmet Çağdaş Biçen , Meric Unal , Ahmet Ekin , Mustafa Ozkan

https://doi.org/10.17343/sdutfd.998025

Abstract

Amaç
Bu çalışmanın amacı rotator manşet yırtığı olan hastalarda
biseps lezyonlarını saptamada manyetik rezonans
görüntülemenin (MRG) doğruluğunu değerlendirmektir.
Gereç ve Yöntem
Ocak 2012 ile Şubat 2020 arasında opere edilen toplam
168 hasta çalışmaya dahil edildi. Tüm hastalara
rotator manşet yırtığı tanısı ile artroskopik cerrahi uygulandı.
Tüm hastalar genel anestezi altında ve plaj
sandalyesi pozisyonunda ameliyat edildi. Demografik
veriler ve ameliyat öncesi MRG bulguları kaydedildi.
Artroskopik bulgular standart referans olarak kabul
edildi ve preoperatif MRG kayıtları ile korele edildi.
Bulgular
Ameliyat öncesi görüntülerde 118 (%70.2) olguda tam
kat, 50 (%29.8) olguda parsiyel yırtık saptandı. Labrum/
SLAP lezyonları 18 (%10,7) olguda tespit edildi.
51 (%30.4) olguda biseps patolojisi bildirilmişti. Ameliyatlar
sırasında 41 (%24,4) olguda ameliyat öncesi
tespit edilen lezyonların yanı sıra ek patolojiler gözlemledik.
Rotator manşet ve labrum/SLAP onarımları
aynı cerrahi seanslarda yapıldı. Yeni tespit edilen lezyonların
çoğunluğu 26 (%15,5) vakada tespit edilen
biseps lezyonlarıydı. 41 (%24.2) olguda biseps lezyonları
için tenodez, tenoliz veya tenotomi uygulandı.
MRG negatif olan 26 olguda LHBT cerrahisi uygulandı.
Biseps lezyonları 77 (%45.8) olguda intraoperatif
olarak doğrulandı; MRG'nin bu lezyonları saptamadaki
doğruluğu %66,2 idi.
Sonuç
Biseps lezyonları omuzun sık görülen patolojileri arasındadır.
Ameliyat öncesi MRG omuzun değerlendirilmesinde
önemlidir, ancak MRG'nin biseps bozukluklarını
tespit etmedeki etkinliği sınırlı olabilir. LHBT
lezyonlarının tanı ve tedavisinde artroskopik cerrahi
önemli bir rol oynar.

Keywords

Biceps, biseps tendonunun uzun başı, omuz artroskopisi, rotator manşet yırtığı

EFFICACY OF PREOPERATIVE MRI IN DETECTING BICEPS TENDON PATHOLOGIES IN ROTATOR CUFF TEARS: CORRELATION OF MRI AND INTRAOPERATIVE FINDINGS

Abstract

Objective
The aim of this study is to evaluate the accuracy
of magnetic resonance imaging (MRI) in detecting
biceps lesions in patients with rotator cuff tears.
Material and Methods
A total of 168 patients operated on between January
2012 and February 2020 were included in the study.
All the patients underwent arthroscopic surgery
with the diagnosis of rotator cuff tears. All patients
were operated on under general anesthesia and
in the beach chair position. Demographic data and
preoperative MRI findings were recorded. Arthroscopic
findings were accepted as the standard reference and
correlated with preoperative MRI records.
Results
In preoperative images, full-thickness rotator cuff
tears were identified in 118 (70.2%) cases and partialthickness
tears in 50 (29.8%) cases. Labrum/SLAP
lesions were detected in 18 (10.7%) cases. Biceps
disorders were reported in 51 (30.4%) cases. During
the surgeries, we observed additional pathologies in
41 (24.4%) cases besides the preoperatively detected
lesions. Rotator cuff and labrum/SLAP repairs were
performed in the same surgical sessions. The majority
of newly detected lesions were biceps lesions, being
identified in 26 (15.5%) cases. In 41 (24.2%) cases
tenodesis, tenolysis, or tenotomy were performed
for biceps lesions. LHBT surgery was performed in
26 cases with negative MRI. Biceps lesions were
confirmed in 77 (45.8%) cases intraoperatively;
therefore, the accuracy of MRI in detecting these
lesions was 66.2%.
Conclusion
Biceps lesions are among the common pathologies
of the shoulder. Preoperative MRI is important in
evaluation of the shoulder, but the efficacy of MRI may
be limited in detecting biceps disorders. Arthroscopic
surgery is crucial in diagnosis and treatment of LHBT
lesions.

Keywords

Biceps, long head of the biceps tendon, shoulder arthroscopy, rotator cuff tear.

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