High Sensitivity and Specificity of Magnetic Resonance Arthrography for Labral Tears, Rotator Cuff Tears, Hill-Sachs Lesions, and Bankart Lesions: A Systematic Review and Meta-analysis

IF 5.4 1区医学 Q1 ORTHOPEDICS Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-09-01 Epub Date: 2025-02-04 DOI:10.1016/j.arthro.2025.01.048

Menna Elbadry M.B.B.C.H. , Mahmoud Shaaban Abdelgalil M.B.B.C.H. , Ruaa Mustafa Qafesha M.B.B.C.H. , Asem Ahmed Ghalwash M.B.B.C.H. , Hosny Elkhawaga B.Sc. , Amro Mamdouh Abdelrehim M.B.B.C.H. , Doaa Mashaly M.B.B.C.H. , Hatem Eldeeb M.B.B.C.H. , Mostafa Mahmoud Naguib M.B.B.C.H. , Yousef Ahmed Yousef Selim M.D.

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Abstract

Purpose

To compare the diagnostic value of magnetic resonance arthrography (MRA) in different shoulder lesions using arthroscopy as gold standard.

Methods

We performed a comprehensive search in Cochrane, Scopus, PubMed, and Web of Science databases for articles that reported the diagnostic value of MRA in diagnosing labral tears, rotator cuff tears (RCTs), Hill-Sachs, and Bankart injuries. We used arthroscopic surgery as a reference standard for comparison. The quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool. We pooled the collected data and used Stata/MP17 to generate summary statistics.

Results

We identified a total of 53 articles compromising 5,487 patients. The sensitivity and specificity for Hill-Sachs lesions were 0.94 (95% confidence interval [CI] 0.80-0.99) and 0.89 (95% CI 0.77-0.95), Bankart lesions were 0.94 (95% CI 0.89-0.97) and 0.99 (95% CI 0.90-1.00), anterior labral tears were 0.91 (95% CI 0.82-0.96) and 0.96 (95% CI 0.90-0.99), posterior labral tears were 0.74 (95% CI 0.58-0.86) and 0.98 (95% CI 0.86-1.00), superior labral tears were 0.77 (95% CI 0.62-0.88) and 0.83 (95% CI 0.54-0.95), SLAP lesions were 0.86 (95% CI 0.80-0.90) and 0.91 (95% CI 0.83-0.96), partial-thickness RCTs were 0.67 (95% CI 0.45-0.83) and 0.92 (95% CI 0.78-0.97), whereas full-thickness RCTs were 0.97 (95% CI 0.91-0.99) and 0.99 (95% CI 0.93-1).

Conclusions

In conclusion, MRA is a sensitive and specific imaging method for identifying anterior labrum lesions, full-thickness RCTs, Bankart, SLAP, and Hill-Sachs lesions, with lower accuracy in partial-thickness RCTs, both posterior and superior labrum.

Level of Evidence

Level III, meta-analysis of prospective and retrospective cohort and case-control studies.

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磁共振关节造影对唇部撕裂、肩袖撕裂、Hill-Sachs病变和Bankart病变的高灵敏度和特异性：一项系统综述和荟萃分析。

目的：比较以关节镜为金标准的MRA对不同肩关节病变的诊断价值。方法：我们在Cochrane、Scopus、PubMed和WOS数据库中全面检索报道MRA在诊断唇裂、肩袖撕裂（RCT）、Hill-Sachs和Bankart损伤中的诊断价值的文章。我们以关节镜手术作为对照标准。使用诊断准确性研究质量评估（QUADAS-2）工具评估研究的质量。我们将收集到的数据进行汇总，并使用Stata/MP17生成汇总统计数据。结果：我们共发现53篇文章，涉及5487例患者。Hill Sachs病变的敏感性和特异性分别为0.94 [95% CI 0.80, 0.99]和0.89 [95% CI 0.77, 0.95]， bankart病变分别为0.94 [95% CI 0.89,0.97]和0.99 [95% CI 0.90,1.00]，前唇撕裂分别为0.91 [95% CI 0.82,0.96]和0.96 [95% CI 0.90, 0.99]，后唇撕裂分别为0.74 [95% CI 0.58, 0.86]和0.98 [95% CI 0.86]，1.00]上唇撕裂分别为0.77 [95% CI 0.62,0.88]和0.83 [95% CI 0.54,0.95]， SLAP病变分别为0.86 [95% CI 0.80,0.90]和0.91 [95% CI 0.83,0.96]，部分厚度rct分别为0.67 [95% CI 0.45,0.83]和0.92 [95% CI 0.78,0.97]，全层rct分别为0.97 [95% CI 0.91,0.99]和0.99 [95% CI 0.93,1]。结论：综上所述，MRA是一种识别前唇病变、全层肩袖撕裂、bankart、SLAP和Hill-Sachs病变的敏感和特异的成像方法，但对后唇和上唇部分肩袖撕裂的准确性较低。

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来源期刊

Arthroscopy-The Journal of Arthroscopic and Related Surgery 医学-外科

CiteScore

9.30

自引率

17.00%

发文量

555

审稿时长

58 days

期刊介绍： Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.