Diagnostic Accuracy Meta-analysis: MRI And Direct MR Arthrography Indetection Of Glenoidlabral Lesion

Purpose:MR imaging (MRI) and direct MR arthrography (D-MRAR) in detection of glenoid labral lesions using Meta-analysis.Methods:Establish a strategy of literature search, pertinent published and unpublished electrical databases were reviewed, filter each study according to the inclusion criteria document, Methodological quality of each study was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) tool. A two-by-two table of TP、 FP、 FN and TP of MRI and D-MRAR was constructed against surgical outcomes.Literatures are divided into two groups according study characteristics. The first group compared MRI with D-MRAR in detection of overall glenoid labrum lesions; The second group is set up for detection of subtype of glenohumeral labral lesions.Statistical analysis was performed using RevMan5.1and Meta-Discl.4. First of all, choosing statistic models according to result of heterogeneity test; Secondly, pooled quantitative value of diagnostic tests were performed, the map of forest and Receiver Operating Characteristic curve (ROC) were draw. Finally, estimate the statistics processing by sensitivity analysis, furthermore, assess publication bias by funnel plot.Results:Forty-two papers assessing2821shoulders were reviewed.1. Paired MRI and D-MRAR was assessed in4studies, both MRI and D-MRAR presented with a high diagnosis accuracy, and D-MRAR appeared to be marginally superior to MRI in detecting shoulder labral lesions on ROC curve interpretation. Thirty studies of first group also indicated that D-MRAR better than MRI in detection of glenoid labral lesions;2. a stratified analysis of magnetic resonance field display that diagnosis accuracy of1.0-3.0tesla machine superior to0.2-0.3T, however, the result were turn out to be unsteadiness through sensitivity analysis;3. For paired study of subtype labrum lesions, the diagnostic accuracy of MRI and D-MRAR from high to low is anterior、 superior、 posterior.4. For detection lesion of superior and posterior glenoid labrum, MR arthrography has greater diagnostic accuracy than MRI. Conclusions:1. MRI and MR Arthrography may be useful adjuncts in the diagnosis of glenoid labral lesions. D-MRAR appears to be marginally superior to MRI.2. There was no substantial difference between1.0-3.0Tesla MR machine and0.2-0.3T for diagnosis glenoid larum lesions.3. The diagnostic accuracy of subtype labrum lesions by MRI and D-MRAR from high to low is anterior、superior、posterior. D-MRAR better than MRI on diagnostic of superior and posterior labral lesions.