Accuracy of MRI Diagnosis of Meniscal Tears of the Knee: A Meta-Analysis and Systematic Review

Abstract

This study aimed to evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in patients with suspected meniscal tears. PubMed, Cochrane, Embase database updated to November 2017 were searched by the index words to identify qualified studies, including prospective cohort studies and cross-sectional studies. Literature was also identified by tracking using reference lists. Heterogeneity of the included studies was reviewed to select proper effects model for pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were performed for meniscal tears. A total of 17 studies were involved in this meta-analysis to explore the diagnostic accuracy of MRI for meniscal tears. The global sensitivity and specificity of MRI of meniscal tears were 92.0% (95% confidence interval [CI]: 88.0–95.0%) and 90.0% (95% CI: 85.0–95.0%) in medial meniscal tears, and 80.0% (95% CI: 66.0–89.0%) and 95.0% (95% CI: 91.0–97.0%) in lateral meniscal tears, respectively. Moreover, the global positive and negative likelihood ratio of MRI of meniscal tears were 10.33 (95% CI: 6.04–17.67) and 0.09 (95% CI: 0.05–0.14) in medial meniscal tears; 16.48 (95% CI: 8.81–30.83) and 0.21 (95% CI: 0.12–0.37) in lateral meniscal tears, respectively. The global DOR was 81.69 (95% CI: 37.94–175.91) in medial meniscal tears and 56.59 (95% CI: 22.51–142.28) in lateral meniscal tears. The results of area under the SROC indicated high accuracy in medial meniscal tears (area under the curve [AUC] = 0.97, 95% CI: 0.95–0.98) and lateral meniscal tears (AUC = 0.96, 95% CI: 0.94–0.97). This review presents a systematic review and meta-analysis to evaluate the diagnostic accuracy of MRI of meniscal tears. Moderate-to-strong evidence suggests that MRI appears to be associated with higher diagnostic accuracy for detecting medial and lateral meniscal tears.

Accuracy of standard magnetic resonance imaging sequences for meniscal and chondral lesions versus knee arthroscopy. A prospective case‐controlled study of 719 cases

“…An accurate non‐invasive imaging modality could reduce the use of knee arthroscopy for diagnosis. The accuracy of MRI for the diagnosis of meniscal tears has been reported to be 80–96% in other studies, but this depends upon the specific MRI protocols used 11–16 . Although these figures may appear impressive, clinical assessment has similar levels of accuracy at a fraction of the cost 14,17 .…”

Comparison of Accuracy in Expert Clinical Examination versus Magnetic Resonance Imaging and Arthroscopic Exam in Diagnosis of Meniscal Tear

“…In a meta-analysis by Wang et al, the international specificity and sensitivity of MRI of meniscal tears were 95.0% (95% confidence interval (CI): 91.0-97.0%) and 80.0% (95% CI: 66.0-89.0%) in lateral meniscal tears and 90.0% (95% CI: 85.0-95.0%) and 92.0% (95% CI: 88.0-95.0%), respectively [18].…”

Diagnosis and Management of Articular Cartilage and Meniscus Pathology in the Posterior Cruciate Ligament-Injured Knee

“…27 While computed tomography may be an efficient and effective diagnostic modality in these cases, MRI provides the most consistent imaging modality for accurately diagnosing ligamentous, meniscal, and full-thickness chondral and osteochondral lesions. 8,[28][29][30][31] However, the accuracy of standard MRI is much lower for diagnosis of partial-thickness cartilage defects and some types of meniscal tears. [31][32][33] Complete and accurate preoperative diagnosis of all intra-articular injuries is paramount to appropriately inform and educate patients, guide treatment algorithms to address the joint as a whole, and ensure all applicable options are available for the index surgery whenever possible.…”