Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.
National Defense Medical Center, Taipei, Taiwan.
Sci Rep. 2021 Jan 28;11(1):2587. doi: 10.1038/s41598-021-82351-9.
Scaphoid fractures are the most common carpal fractures. Diagnosing scaphoid fractures is challenging. Recently, cone-beam computed tomography (CBCT) has been shown to be a promising strategy for diagnosing scaphoid fractures. The diagnostic performance of CBCT remains inconclusive in the literature. Through a systematic review and meta-analysis, our study aims to determine the diagnostic performance of CBCT for diagnosing scaphoid fractures. Five databases were searched up to March 25, 2020. We included prospective and retrospective studies describing the diagnostic accuracy of CBCT for scaphoid fractures in adult patients. QUADAS-2 tool was used to assess the quality of the included studies. Four studies (n = 350) were included in the meta-analysis. Three of the four studies had high bias risk. The result showed that CBCT had a pooled sensitivity of 0.88 and a pooled specificity of 0.99 for scaphoid fracture diagnosis. The heterogeneities of sensitivity and specificity were substantial. The area under the summary receiver operating characteristic curve was 0.98. No significant publication bias was observed. The result suggested that the diagnostic performance of CBCT for scaphoid fracture was excellent. The certainty of current evidence is low. Further well-designed studies with large sample sizes are warranted to confirm this finding.
舟状骨骨折是最常见的腕骨骨折。诊断舟状骨骨折具有挑战性。最近，锥形束 CT（CBCT）已被证明是诊断舟状骨骨折的一种很有前途的策略。CBCT 在文献中的诊断性能仍存在争议。通过系统评价和荟萃分析，我们的研究旨在确定 CBCT 诊断舟状骨骨折的诊断性能。截至 2020 年 3 月 25 日，我们检索了五个数据库。我们纳入了描述成人患者 CBCT 诊断舟状骨骨折的诊断准确性的前瞻性和回顾性研究。QUADAS-2 工具用于评估纳入研究的质量。Meta 分析纳入了 4 项研究（n=350）。其中 3 项研究的偏倚风险较高。结果表明，CBCT 对舟状骨骨折的诊断敏感度为 0.88，特异度为 0.99。敏感度和特异度的异质性较大。汇总受试者工作特征曲线下的面积为 0.98。未观察到明显的发表偏倚。结果表明，CBCT 对舟状骨骨折的诊断性能良好。但目前证据的确定性较低。需要进一步设计良好、样本量大的研究来证实这一发现。
