The Diagnostic Value Of MRI In The CSCIWOFD Of Disc-Liga-Mentious Complex Injury:A Meta-Analysis

Objective:The meta-analysis was evaluated the diagnostic value of MRI for CSCIWOFD with disc-ligamentious complex injury(DLC).Methods:The literature searched up to December 2018 was performed on CBM,VIP,CNKI,Wanfang,PubMed,Embase,Cochrane Library and Web of Science databases.Ac-cording to the inclusion and exclusion criteria,the literature was evaluated the quality for the QUADAS quality evaluation tool,and was extracted data.The Meta-disc1.4 and Stata13 software obtained each statistic.The SROC curve to make was calculated the AUC.Deek,s funnel plot was evaluated whether publication bias.Results:In the final 18 articles,914 cases with CSCIWOFD,including 667 male patients and 247 female patients,were included in this meta-analysis.1)17 articles described the CSCIWOFD with anterior longitudinal ligament injury.The result showed[SEN=0.86,95%CI(0.83-0.88)],[SPE=0.84,95%CI(0.81-0.87)],[LR+=4.24,95%CI(2.50-7.21)],I~2=81.8%],[LR-=0.2,95%CI(0.14-0.30),I~2=65.1%],[DOR=25.2,95%CI(11.51-55.37),I~2=69.9%],SROC curve to make was calculated as AUC)=0.90,Q=0.83.Deek,s funnel plot showed that there was publication bias in this study.2)8 articles described CSCIWOFD with intervertebral disc injury.The result showed[SEN=0.70,95%CI(0.63-0.77)],[SPE=0.80,95%CI(0.72-0.86),[LR+=2.68,95%CI(1.44-4.98)],I~2=68.2%],[LR-=0.37,95%CI(0.24-0.57),I~2=48.5%],[DOR=6.84,95%CI(4.11-11.39),I~2=39.1%],SROC curve to make was calculated as AUC=0.80,Q=0.73.In this study,Deek,s funnel plot showed that there was no publication bias.3)9 articles described CSCIWOFD with posterior longitudinal ligament injury.The result showed[SEN=0.84,95%CI(0.80-0.88)],[SPE=0.88,95%CI(0.84-0.91)],[LR+=4.7,95%CI(1.74-13.08),I~2=92%],[(LR-=0.24,95%CI(0.14-0.43),I~2=75.2%],[DOR=23.2,95%CI(6.52-83.25),I~2=80.3%],SROC curve to make was calculated as AUC=0.89,Q=0.82.Deek,s funnel plot showed that there was publication bias in this study.Conclusion:?The anterior longitudinal ligament signal of change is of high diagnostic value in CSCIWOFD with DLC injury and judges the cervical stability.?The AUC=0.80(AUC<0.9)of intervertebral disc of signal changes is of low diagnostic value and unreliable clinical value in CSCIWOFD with DLC injury.This requires comprehensive consideration and analysis of multiple factors,and precise localization combined with spinal cord signal changes in plane.?AUC=0.89(AUC<0.9)is a moderate value in the diagnosis of CSCIWOFD with DLC injury.This is publication bias and is limited by the quality of the study and the influence of national factors.It needs to be verified by multi-center and high-quality studies.