Tawa Nassib, Rhoda Anthea, Diener Ina
Department of Rehabilitative Sciences, College of Health Sciences, Jomo Kenyatta University of Agriculture & Technology, P.O. Box 62 000 00200, Nairobi, Kenya.
Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Private Bag X 17, Bellville, 7535, Republic of South Africa.
BMC Musculoskelet Disord. 2016 Sep 6;17(1):386. doi: 10.1186/s12891-016-1236-z.
MRI is considered to be the diagnostic tool of choice in diagnosing nerve root compromise among patients presenting with clinical suspicion of lumbo-sacral radiculopathy. There exists controversy among researchers and clinicians regarding the diagnostic utility and accuracy of MRI in detecting nerve root compromise and radiculopathy. This review evaluated 4 primary diagnostic accuracy studies that specifically assessed the accuracy of MRI in detecting nerve root compromise, as established in the current literature.
Eight electronic data bases were searched for relevant articles from inception until January 2014. All primary diagnostic studies which investigated the accuracy of MRI in diagnosing nerve root compromise among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the 'Quality Assessment of Diagnostic tests Accuracy Studies' criteria.
Four studies qualified for inclusion in this review. The sensitivity of MRI in detecting lumbar nerve root compromise was very low at 0.25 (95 % CI) while the specificity was relatively high at 0.92 (95 % CI).
There is lack of sufficient high quality scientific evidence in support or against the use of MRI in diagnosing nerve root compression and radiculopathy. Therefore, clinicians should always correlate the findings of MRI with the patients' medical history and clinical presentation in clinical decision making.
对于临床怀疑有腰骶神经根病的患者，MRI被认为是诊断神经根受压的首选诊断工具。在研究人员和临床医生中，关于MRI在检测神经根受压和神经根病方面的诊断效用和准确性存在争议。本综述评估了4项主要的诊断准确性研究，这些研究专门评估了MRI在检测神经根受压方面的准确性，这是当前文献中已确立的。
检索了8个电子数据库，查找从数据库建立至2014年1月的相关文章。筛选所有调查MRI在诊断有下背部和下肢牵涉痛症状患者神经根受压准确性的主要诊断研究以纳入。检索符合条件的研究，并使用“诊断试验准确性研究质量评估”标准对方法学质量进行独立评估。
4项研究符合纳入本综述的条件。MRI检测腰神经根受压的敏感性非常低，为0.25（95%可信区间），而特异性相对较高，为0.92（95%可信区间）。
缺乏足够的高质量科学证据支持或反对使用MRI诊断神经根受压和神经根病。因此，临床医生在临床决策时应始终将MRI结果与患者的病史和临床表现相关联。
