Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
Eur Radiol. 2019 Feb;29(2):566-577. doi: 10.1007/s00330-018-5604-y. Epub 2018 Jul 5.
To perform a systematic review and meta-analysis to identify magnetic resonance imaging (MRI) features that will aid in the diagnosis of adhesive capsulitis of the shoulder (ACS) and provide a summary of the diagnostic accuracy of the identified features METHODS: The MEDLINE and EMBASE databases were searched for studies assessing the diagnostic accuracy of MRI features of ACS. Overlapping descriptors used to denote the same imaging finding in different studies were subsumed under a single feature. The pooled accuracy including the diagnostic odd ratios (DORs) with 95% confidence intervals (CIs) of the identified features was calculated using a bivariate random-effects model.
In total, 15 studies were included, and 74 overlapping descriptors were subsumed under six features. All six features were found to be informative for ACS diagnosis [coracohumeral ligament thickening: DOR, 13; 95% CI, 6-29; fat obliteration of the rotator interval (RI): DOR, 8; 95% CI, 3-24; RI enhancement: DOR, 44; 95% CI, 14-141; axillary joint capsule enhancement: DOR, 52; 95% CI, 27-98; inferior glenohumeral ligament (IGHL) hyperintensity: DOR, 31; 95% CI, 8-115; IGHL thickening: DOR, 28; 95% CI, 11-70]. The sensitivity and specificity of enhancement of the RI and axillary joint capsule and IGHL hyperintensity were > 80%.
Six informative MRI features for ACS diagnosis were identified in this study with RI and axillary joint capsule enhancement and IGHL hyperintensity showing the highest diagnostic accuracy. Informative features observed on non-arthrogram MRI can be as helpful as features observed on direct magnetic resonance arthrography for ACS diagnosis.
• Six informative MRI features for ACS diagnosis were identified (diagnostic odds ratio > 1). • RI and axillary joint capsule enhancement and IGHL hyperintensity showed high sensitivities/specificities (> 80%). • The use of non-arthrogram MRI is recommended for ACS diagnosis.
进行系统评价和荟萃分析，以确定有助于诊断粘连性肩关节囊炎 (ACS) 的磁共振成像 (MRI) 特征，并总结已确定特征的诊断准确性。
检索 MEDLINE 和 EMBASE 数据库，以评估 ACS 的 MRI 特征诊断准确性的研究。在不同研究中用于表示同一影像学发现的重叠描述符被归入单个特征下。使用双变量随机效应模型计算汇总准确性，包括诊断比值比 (DOR) 和 95%置信区间 (CI)。
共纳入 15 项研究，74 个重叠描述符归入 6 个特征下。所有 6 个特征均有助于 ACS 诊断[喙肱韧带增厚：DOR，13；95%CI，6-29；旋转间隔脂肪消失 (RI)：DOR，8；95%CI，3-24；RI 增强：DOR，44；95%CI，14-141；腋窝关节囊增强：DOR，52；95%CI，27-98；下盂肱韧带 (IGHL) 高信号：DOR，31；95%CI，8-115；IGHL 增厚：DOR，28；95%CI，11-70]。RI 和腋窝关节囊增强以及 IGHL 高信号的灵敏度和特异性均>80%。
本研究确定了 6 个有助于 ACS 诊断的有意义的 MRI 特征，其中 RI 和腋窝关节囊增强以及 IGHL 高信号的诊断准确性最高。非关节造影 MRI 上观察到的有意义特征与直接磁共振关节造影上观察到的特征一样有助于 ACS 诊断。
• 确定了 6 个有助于 ACS 诊断的有意义 MRI 特征（诊断比值比>1）。• RI 和腋窝关节囊增强以及 IGHL 高信号具有较高的灵敏度/特异性 (>80%)。• 推荐使用非关节造影 MRI 进行 ACS 诊断。
