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

Öz

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.

Anahtar Kelimeler

• 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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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