Department of Orthopedics, Dongyang Hospital of Traditional Chinese Medicine, Dongyang 322100, Zhejiang, China.
Department of Orthopedics, Tongde Hospital of Traditional Chinese Medicine, Hangzhou 310012, Zhejiang, China.
Clin Imaging. 2024 Oct;114:110273. doi: 10.1016/j.clinimag.2024.110273. Epub 2024 Sep 2.
We aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting bone marrow edema (BME) in patients with lower limb joint injuries.
A thorough literature search was conducted across the PubMed, Embase, and Web of Science databases to identify relevant studies up to April 2024. Studies examining the diagnostic performance of DECT in detecting BME in lower limb joint injuries patients were included. Sensitivity and specificity were evaluated using the inverse variance method and transformed via the Freeman-Tukey double arcsine transformation. Furthermore, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the methodological quality of the included studies.
This meta-analysis included 17 articles involving 625 patients. The pooled sensitivity, specificity, and AUC for DECT in detecting BME in lower limb joint injuries patients were 0.82 (95 % CI: 0.76-0.87), 0.95 (95 % CI: 0.92-0.97), and 0.95 (95 % CI: 0.93-0.97), respectively. The pooled sensitivity of DECT for detecting BME in knee, hip, and ankle joint injuries was 0.80, 0.84, and 0.80, with no significant difference among these joints (P = 0.55). The pooled specificity for knee, hip, and ankle injuries was 0.95, 0.97, and 0.89. Specificity differed significantly among the joints (P < 0.01), with the highest specificity in hip injuries.
Our meta-analysis indicates that DECT demonstrates high diagnostic performance in detecting BME in patients with lower limb joint injuries, with the highest specificity observed in hip joint injuries. To validate these findings, further larger prospective studies are necessary.
本研究旨在评估双能 CT（DECT）在检测下肢关节损伤患者骨髓水肿（BME）中的诊断性能。
通过对 PubMed、Embase 和 Web of Science 数据库进行全面检索，检索截至 2024 年 4 月的相关研究。纳入评估 DECT 检测下肢关节损伤患者 BME 诊断性能的研究。采用逆方差法评估敏感度和特异度，并通过 Freeman-Tukey 双反正弦变换进行转换。此外，还使用诊断准确性研究质量评估工具 2（QUADAS-2）评估纳入研究的方法学质量。
本荟萃分析纳入了 17 项研究，共 625 名患者。DECT 检测下肢关节损伤患者 BME 的汇总敏感度、特异度和 AUC 分别为 0.82（95%CI：0.76-0.87）、0.95（95%CI：0.92-0.97）和 0.95（95%CI：0.93-0.97）。DECT 检测膝关节、髋关节和踝关节 BME 的汇总敏感度分别为 0.80、0.84 和 0.80，各关节间无显著差异（P=0.55）。膝关节、髋关节和踝关节损伤的汇总特异度分别为 0.95、0.97 和 0.89。各关节间的特异度差异有统计学意义（P<0.01），髋关节损伤的特异度最高。
本荟萃分析表明，DECT 对检测下肢关节损伤患者的 BME 具有较高的诊断性能，髋关节损伤的特异度最高。为验证这些发现，需要进一步开展更大规模的前瞻性研究。
