Cappello Zachary J, Kasdan Morton L, Louis Dean S
School of Medicine and Division of Plastic Surgery, University of Louisville, Louisville, KY, USA.
J Hand Surg Am. 2012 Feb;37(2):288-96. doi: 10.1016/j.jhsa.2011.10.035. Epub 2011 Dec 15.
To compare the effectiveness of imaging techniques in aiding and confirming the diagnosis of complex regional pain syndrome (CRPS) type I.
We conducted a meta-analysis of randomized controlled studies that evaluated the effectiveness of 3 different imaging techniques in aiding the diagnosis of CRPS type I. A systematic search in bibliographical databases resulted in 24 studies with 1,916 participants.
To determine the effectiveness of each imaging technique, we determined the average specificity, sensitivity, negative predictive value, and positive predictive value and then statistically compared them using the analysis of variance statistical test, which indicated that compared with magnetic resonance imaging and plain film radiography, triple-phase bone scan had a significantly better sensitivity and negative predictive values. However, there appeared to be no statistical significance between imaging techniques when we evaluated specificity and positive predictive value using the analysis of variance test.
The findings of this meta-analysis support the use of triple-phase bone scan in ruling out CRPS type I, owing to its greater sensitivity and higher negative predictive value than both magnetic resonance imaging and plain film radiography.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic I.
比较成像技术在辅助和确诊Ⅰ型复杂性区域疼痛综合征（CRPS）中的有效性。
我们对评估3种不同成像技术辅助诊断Ⅰ型CRPS有效性的随机对照研究进行了荟萃分析。在文献数据库中进行系统检索，得到24项研究，共1916名参与者。
为确定每种成像技术的有效性，我们确定了平均特异性、敏感性、阴性预测值和阳性预测值，然后使用方差分析统计检验进行统计学比较，结果表明，与磁共振成像和平片X线摄影相比，三相骨扫描的敏感性和阴性预测值明显更好。然而，当我们使用方差分析检验评估特异性和阳性预测值时，成像技术之间似乎没有统计学意义。
这项荟萃分析的结果支持使用三相骨扫描来排除Ⅰ型CRPS，因为它比磁共振成像和平片X线摄影具有更高的敏感性和阴性预测值。
研究类型/证据水平：诊断性Ⅰ级。
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