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Skeletal Radiology
Published in: Skeletal Radiology 10/2019

01-10-2019 | Cruciate Ligament Injury | Scientific Article

Efficiency of knee ultrasound for diagnosing anterior cruciate ligament and posterior cruciate ligament injuries: a systematic review and meta-analysis

Authors: Sun Hwa Lee, Seong Jong Yun

Published in: Skeletal Radiology | Issue 10/2019

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Abstract

Objective

To evaluate the diagnostic performance of knee ultrasound for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries.

Materials and methods

PubMed and EMBASE databases were searched for diagnostic accuracy studies that used ultrasound for diagnosing ACL and PCL injuries. Bivariate and hierarchical summary receiver operating characteristic modeling was used to evaluate diagnostic performance. Subgroup analysis was performed by assessing studies conducted using the ultrasound technique (functional ultrasound versus conventional ultrasound) for diagnosing ACL injury. We performed meta-regression analyses for a potential source of heterogeneity.

Results

Eleven (938 ultrasound/878 patients) and six articles (281 ultrasound/237 patients) were included for ACL and PCL injuries respectively. The summary sensitivity, summary specificity, and area under the hierarchical summary receiver operating characteristic for ACL and PCL injuries were 0.88 (95% confidence interval [CI], 0.81–0.93) and 0.99 (95% CI, 0.49–1.00), 0.96 (95% CI, 0.91–0.98) and 0.99 (95% CI, 0.73–1.00), and 0.97 (95% CI, 0.96–0.98) and 1.00 (95% CI, 0.99–1.00) respectively. In subgroup analysis, there was no significant difference between sensitivity (p = 0.63) and specificity (p = 0.72) of functional and conventional ultrasound. Among the various potential covariates, patient enrollment, patient position, and ultrasound performer were associated with heterogeneity in terms of sensitivity, and proportion of the ACL injury was associated with heterogeneity in terms of specificity.

Conclusion

Knee ultrasound demonstrates high diagnostic performance for ACL and PCL injuries, particularly when performed by experienced musculoskeletal radiologists. Future prospective studies to compare the cost- and time-effectiveness between ultrasound and magnetic resonance imaging and to determine the optimal ultrasound parameters are warranted.
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Metadata
Title
Efficiency of knee ultrasound for diagnosing anterior cruciate ligament and posterior cruciate ligament injuries: a systematic review and meta-analysis
Authors
Sun Hwa Lee
Seong Jong Yun
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 10/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03225-w

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