Diagnostic Performance of MR Arthrography with Anterior Trans-Subscapularis versus Posterior Injection Approach for Subscapularis Tendon Tears at 3.0T

Jung, Joon-Yong; Jee, Won-Hee; Chun, Chang-Woo; Kim, Yang-Soo

doi:10.1007/s00330-016-4467-3

Cited by 12 publications

(12 citation statements)

References 37 publications

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“…7,19,71,94,125,144 The anatomic resolution is good, subtle defects can be depicted by contrast material, and leakage of contrast agents is usually evident, thus enhancing the diagnostic accuracy of FT tears. 26,60,68,120 We found that MRA was also the most accurate method for detecting RCTs regardless of type (FT or PT tear). However, the injection of a contrast agent is an invasive procedure, infections and adverse reactions occur, 44 and the examination time is longer.…”

Section: Discussionmentioning

confidence: 77%

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

Liu

Dong

Shen³

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Many imaging techniques have been developed for the detection of rotator cuff tears (RCTs). Despite numerous quantitative diagnostic studies, their relative accuracy remains inconclusive.Purpose: To determine which of 3 commonly used imaging modalities is optimal for the diagnosis of RCTs.Study Design: Systematic review; Level of evidence, 4.Methods: Studies evaluating the performance of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and ultrasound (US) used in the detection of RCTs were retrieved from the PubMed/MEDLINE and Embase databases. Diagnostic data were extracted from articles that met the inclusion/exclusion criteria. A network meta-analysis was performed using an armbased model to pool the absolute sensitivity and specificity, relative sensitivity and specificity, and diagnostic odds ratio as well as the superiority index for ranking the probability of these techniques.Results: A total of 144 studies involving 14,059 patients (14,212 shoulders) were included in this network meta-analysis. For the detection of full-thickness (FT) tears, partial-thickness (PT) tears, or any tear, MRA had the highest sensitivity, specificity, and superiority index. For the detection of any tear, MRI had better performance than US (sensitivity: 0.84 vs 0.81, specificity: 0.86 vs 0.82, and superiority index: 0.98 vs 0.22, respectively). With regard to FT tears, MRI had a higher sensitivity and superiority index than US (0.91 vs 0.87 and 0.67 vs 0.28, respectively) and a similar specificity (0.88 vs 0.88, respectively). The results for PT tears were similar to the detection of FT tears. A sensitivity analysis was performed by removing studies involving only 1 arm for FT tears, PT tears, or any tear, and the results remained stable.Conclusion: This network meta-analysis of diagnostic tests revealed that high-field MRA had the highest diagnostic value for detecting any tear, followed by low-field MRA, high-field MRI, high-frequency US, low-field MRI, and low-frequency US. These findings can help guide clinicians in deciding on the appropriate imaging modality.

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Section: Discussionmentioning

confidence: 77%

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

Liu

Dong

Shen³

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…In addition, another meta-analysis included 14 studies involving 1216 patients with labral lesions, revealed that MRA had the highest sensitivity and speci city compared with those of MRI and CTA, which indicated that MRA was suggested for use in patients with chronic shoulder symptoms or a pathologic abnormality [32]. MRA has a good diagnostic performance mainly depending on the objective evidence of the leakage of contrast agent, accompanied by a good anatomic resolution and subtle defects depicted by contrast agents [33,34]. Nonetheless, MRA, as an invasive diagnosis modality, has many disadvantages and limitations, including a longer examination time, increased risk of infection and adverse complication [35,36].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of MRA and MRI for The Articular-Sided Partial-Thickness Rotator Cuff Tears: A Meta-Analysis

Dong

et al. 2020

Preprint

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Background: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT).Methods: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under receiver operating characteristic curve (AUC). Results: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65-0.90), 0.96 (95% CI, 0.91-0.98), 68.14 (95% CI, 33.20-139.84) and 0.96 (95% CI, 0.94-0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65-0.87) and 0.97 (95% CI, 0.84-0.99), 47.82 (95% CI, 8.29-275.89) and 0.89 (95% CI, 0.86-0.92), respectively.Conclusions: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears, but only small improvement of sensitivity. Considering the price and invasion of MRA, MRI is recommended as an initial examination to detect patients suspected with articular-side partial-thickness rotator cuff tears.

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“…Additionally, MRA has also the most accurate to detecting the labral lesions of shoulder [48, 49]. The reason that MRA has a good diagnostic value in the detection of full-thickness RCTs is because the objective evidence of the leakage of contrast agent is accompanied by a good anatomic resolution and subtle defects depicted by contrast agents [50, 51]. However, MRA, usually with a longer examination time, will bring the infections and adverse complications because of an invasive procedure of the injection of contrast agent [52].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

Huang

Liu

et al. 2019

J Orthop Surg Res

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Background Numerous quantitatively studies have focused on the diagnosis of bursal-sided partial-thickness rotator cuff tears (RCTs); however, the accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) remains inconclusive. This study was performed systematically to compare the diagnostic value of MRA and MRI for the bursal-sided partial-thickness RCTs. Methods Three electronic databases, PubMed, Embase, and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting bursal-sided partial-thickness RCTs. After screening and diluting out the articles that met the inclusion criteria to be used for statistical analysis, the pooled evaluation indexes include sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC). Results Twelve studies involving 1740 patients and 1741 shoulders were identified. The pooled sensitivity, specificity, DOR, and AUC of MRA to diagnose bursal-sided partial-thickness RCTs were 0.77 (95% CI, 0.67–0.85), 0.98 (95% CI, 0.95–0.99), 73.01 (95% CI, 35.01–152.26), and 0.88 (95% CI, 0.85–0.91), respectively. The pooled sensitivity, specificity, DOR, and AUC of MRI were 0.77 (95% CI, 0.66–0.86) and 0.96 (95% CI, 0.81–0.99), and 37.12 (95% CI, 8.08–170.64) and 0.82 (95% CI, 0.78–0.85), respectively. Conclusions This meta-analysis reveals that MRA and MRI have similar diagnostic value for the diagnosis of bursal-sided partial-thickness rotator cuff tears.

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Diagnostic Performance of MR Arthrography with Anterior Trans-Subscapularis versus Posterior Injection Approach for Subscapularis Tendon Tears at 3.0T

Cited by 12 publications

References 37 publications

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

Diagnostic Value of MRA and MRI for The Articular-Sided Partial-Thickness Rotator Cuff Tears: A Meta-Analysis

Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

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