{"title":"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。","authors":"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.","doi":"10.1016/j.arthro.2025.01.048","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the diagnostic value of magnetic resonance arthrography<span> (MRA) in different shoulder lesions using arthroscopy as gold standard.</span></div></div><div><h3>Methods</h3><div><span>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 </span>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Level of Evidence</h3><div>Level III, meta-analysis of prospective and retrospective cohort and case-control studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3622-3638.e18"},"PeriodicalIF":6.9000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"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.\",\"doi\":\"10.1016/j.arthro.2025.01.048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To compare the diagnostic value of magnetic resonance arthrography<span> (MRA) in different shoulder lesions using arthroscopy as gold standard.</span></div></div><div><h3>Methods</h3><div><span>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 </span>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Level of Evidence</h3><div>Level III, meta-analysis of prospective and retrospective cohort and case-control studies.</div></div>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":\"41 9\",\"pages\":\"Pages 3622-3638.e18\"},\"PeriodicalIF\":6.9000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0749806325000660\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0749806325000660","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
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。
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
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.
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.
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