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Archives of Orthopaedic and Trauma Surgery

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01-07-2012 | Orthopaedic Surgery

A meta-analysis of the diagnostic test accuracy of MRA and MRI for the detection of glenoid labral injury

Authors: Toby O. Smith, Benjamin T. Drew, Andoni P. Toms

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2012

Abstract

Purpose

Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) have gained increasing favour in the assessment of patients with suspected glenoid labral injuries. The purpose of this study was to determine the diagnostic accuracy of MRI or MRA in the detection of gleniod labral lesions.

Materials and methods

A systematic review was undertaken of the electronic databases Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED and CINAHL, in addition to a search of unpublished literature databases. All studies which compared the ability of MRI or MRA (index test) to assess gleniod labral tears or lesions, when verified with a surgical procedure (arthroscopy or open surgery—reference test) were included. Data extraction and methodological appraisal using the QUADAS tool were both conducted by two reviewers independently. Data were analysed through a summary receiver operator characteristic curve and pooled sensitivity and specificity analysis were calculated with 95% confidence intervals.

Results

Sixty studies including 4,667 shoulders from 4,574 patients were reviewed. There appeared slightly greater diagnostic test accuracy for MRA over MRI for the detection of overall gleniod labral lesions (MRA-sensitivity 88%, specificity 93% vs. MRI sensitivity 76% vs. specificity 87%). Methodologically, studies recruited and identified their samples appropriately and clearly defined the radiological procedures. In general, it was not clearly defined why patients were lost during the study, and studies were poor at recording whether the same clinical data were available to the radiologist interpreting the MRI or MRA as would be available in clinical practice. Most studies did not state whether the surgeon interpreting the arthroscopic procedure was blinded to the results of the MR or MRA imaging.

Conclusions

Based on the available literature, overall MRA appeared marginally superior to MRI for the detection of glenohumeral labral lesions.

Level of Evidence: Level 2a.

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Title: A meta-analysis of the diagnostic test accuracy of MRA and MRI for the detection of glenoid labral injury
Authors: Toby O. Smith
Benjamin T. Drew
Andoni P. Toms
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1493-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A meta-analysis of the diagnostic test accuracy of MRA and MRI for the detection of glenoid labral injury

Abstract

Purpose

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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