Department of Orthopedics and Traumatology, Uzsoki Hospital, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Orthopaedics, Semmelweis University, Budapest, Hungary.
Injury. 2024 Sep;55 Suppl 3:111730. doi: 10.1016/j.injury.2024.111730. Epub 2024 Sep 17.
The gold standard diagnostic method for acute lateral ankle ligament sprain is magnetic resonance imaging (MRI). However, it is hardly accessible and is time-consuming. Therefore, additional diagnostic methods are warranted. Point-of-care ultrasound, on the other hand, is inexpensive, widely available, time-efficient testing method.
Therefore, the aim of this meta-analysis is to determine the diagnostic accuracy of ultrasound for acute ankle ligament injuries compared to MRI.
In our systematic review and meta-analysis, we followed the recommendations of the Cochrane Handbook. We searched the following databases from inception to March 31, 2022: Medline (PubMed), EMBASE, and Cochrane Library. Eligible studies investigated the diagnostic accuracy of US compared to MRI for diagnosing acute lateral ankle ligament injuries. Finally, we calculated pooled sensitivity and specificity with a 95 % confidence interval (CI).
Eight studies met our eligibility criteria, involving 434 patients. For anterior tibiofibular ligament (ATFL) injury, the summary sensitivity and specificity were Se = 0.97 (CI: 0.89-0.99) and Sp = 0.93 (CI: 0.84-0.97). For calcaneofibular ligament (CFL) injury, the summary sensitivity and specificity were Se.: Se = 0.81 (CI: 0.58-0.93) and Sp = 0.92 [0,81;0,97]. In addition, subgroup analysis based on US performed by different types of investigators was comparable between each other (radiologist group Se = 0.98, CI: 0.24-1, and Sp = 0.91, CI: 0.74-0.97, and the orthopedic/ emergency department group Se = 0.96, CI: 0-1, and Sp = 0.97, CI: 0-1).
Ultrasound showed high diagnostic accuracy for acute lateral ankle ligament injury, irrespective of the investigator. Therefore, based on the current available data, it could be used in primary diagnostics of acute lateral ankle ligament injury.
急性外踝韧带扭伤的金标准诊断方法是磁共振成像（MRI）。然而，它难以获得且耗时。因此，需要额外的诊断方法。另一方面，即时护理超声检查是一种廉价、广泛可用、高效的测试方法。
因此，本荟萃分析的目的是确定超声诊断急性踝关节韧带损伤的准确性与 MRI 相比。
在我们的系统评价和荟萃分析中，我们遵循了 Cochrane 手册的建议。我们从成立到 2022 年 3 月 31 日在以下数据库中进行了搜索：Medline（PubMed）、EMBASE 和 Cochrane 图书馆。合格的研究调查了 US 与 MRI 相比诊断急性外踝韧带损伤的诊断准确性。最后，我们用 95%置信区间（CI）计算了合并的敏感性和特异性。
八项研究符合我们的纳入标准，涉及 434 名患者。对于前胫腓韧带（ATFL）损伤，汇总敏感性和特异性分别为 Se = 0.97（CI：0.89-0.99）和 Sp = 0.93（CI：0.84-0.97）。对于跟腓韧带（CFL）损伤，汇总敏感性和特异性分别为 Se = 0.81（CI：0.58-0.93）和 Sp = 0.92 [0，81；0，97]。此外，根据不同类型的调查员进行的 US 亚组分析彼此之间具有可比性（放射科医生组 Se = 0.98，CI：0.24-1，Sp = 0.91，CI：0.74-0.97，和骨科/急诊部组 Se = 0.96，CI：0-1，Sp = 0.97，CI：0-1）。
超声对急性外踝韧带损伤具有较高的诊断准确性，与调查员无关。因此，根据目前可用的数据，它可以用于急性外踝韧带损伤的初步诊断。
