Liu Fanxiao, Cheng Xiangyun, Dong Jinlei, Zhou Dongsheng, Han Shumei, Yang Yongliang
Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong.
Department of Orthopaedics, The 2nd Hospital of Shanxi Medical University, Taiyuan, Shanxi.
Medicine (Baltimore). 2020 Mar;99(12):e19579. doi: 10.1097/MD.0000000000019579.
Numerous quantitatively based studies measuring the accuracy of MRI and MRA for the diagnosis of rotator cuff tears remain inconclusive. In order to compare the accuracy of MRI with MRA in detection of rotator cuff tears a meta-analysis was performed systematically.
PubMed/Medline and Embase were utilized to retrieve articles comparing the diagnostic performance of MRI and MRA for use in detecting rotator cuff tears. After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis the pooled evaluation indexes including sensitivity and specificity as well as hierarchical summary receiver operating characteristic (HSROC) curves with 95% confidence interval (CI) were calculated.
Screening determined that 12 studies involving a total of 1030 patients and 1032 shoulders were deemed viable for inclusion in the meta-analysis. The results of the analysis showed that MRA has a higher sensitivity and specificity than MRI for the detection of any tear; similar results were observed in the detection of full-thickness tears. However, for the detection of partial-thickness tear, MRI has similar performance with MRA.
MRI is recommended to be a first-choice imaging modality for the detection of rotator cuff tears. Although MRA have a higher sensitivity and specificity, it cannot replace MRI after the comprehensive consideration of accuracy and practicality.
众多基于定量分析的研究在测量MRI和MRA诊断肩袖撕裂的准确性方面尚无定论。为了系统比较MRI与MRA在检测肩袖撕裂方面的准确性,我们进行了一项荟萃分析。
利用PubMed/Medline和Embase检索比较MRI和MRA用于检测肩袖撕裂的诊断性能的文章。在筛选并剔除符合纳入标准用于统计分析的文章后,计算合并评估指标,包括敏感性和特异性,以及具有95%置信区间(CI)的分层汇总接受者操作特征(HSROC)曲线。
筛选确定12项研究共涉及1030例患者和1032个肩部,被认为可纳入荟萃分析。分析结果表明,MRA在检测任何撕裂方面比MRI具有更高的敏感性和特异性;在检测全层撕裂方面也观察到类似结果。然而,在检测部分厚度撕裂方面,MRI与MRA表现相似。
建议将MRI作为检测肩袖撕裂的首选成像方式。尽管MRA具有更高的敏感性和特异性,但综合考虑准确性和实用性后,它不能替代MRI。