Toby O Smith1, Benjamin T Drew, Andoni P Toms. 1. Faculty of Medicine and Health Sciences, University of East Anglia, Queen's Building, Norwich, UK. toby.smith@uea.ac.uk
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databases Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED and CINAHL, in addition to a search of unpublished literature databases.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.
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.
Authors: Kevin J McHale; George Sanchez; Kyle P Lavery; William H Rossy; Anthony Sanchez; Marcio B Ferrari; Matthew T Provencher Journal: Arthrosc Tech Date: 2017-06-19
Authors: Marc Banerjee; Jonas Müller-Hübenthal; Stefan Grimme; Maurice Balke; Bertil Bouillon; Rolf Lefering; Axel Goßmann; Sven Shafizadeh Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-06-13 Impact factor: 4.342
Authors: Peter Brownson; Oliver Donaldson; Michael Fox; Jonathan L Rees; Amar Rangan; Anju Jaggi; Graham Tytherleigh-Strong; Julie McBernie; Michael Thomas; Rohit Kulkarni Journal: Shoulder Elbow Date: 2015-05-26
Authors: Jeroen E Markenstein; Kjell C C J Jaspars; Victor P M van der Hulst; W Jaap Willems Journal: Skeletal Radiol Date: 2014-01-18 Impact factor: 2.199
Authors: Fernando Ruiz Santiago; Alberto Martínez Martínez; Pablo Tomás Muñoz; José Pozo Sánchez; Antonio Zarza Pérez Journal: Quant Imaging Med Surg Date: 2017-08