The diagnostic accuracy of magnetic resonance imaging for anterior cruciate ligament injury in comparison to arthroscopy: a meta-analysis

Abstract

We performed this meta-analysis to examine the diagnostic accuracy of MRI for the diagnosis of anterior cruciate ligament (ACL) injury in comparison to arthroscopy. We also compared the diagnostic accuracy of MRI with magnetic field intensities (MFI) greater than or equal to 1.5T with those below 1.5T, in addition to different MRI sequences. Studies relevant to the diagnosis of ACL injury by MRI and arthroscopy were analyzed. Computer and manual retrieval were carried out on studies published between January 1, 2006 and May 31, 2016. Twenty-one papers were included. Neither threshold nor non-threshold effects were present (p = 0.40, p = 0.06). The pooled sensitivity (SE), specificity (SP), positive likelihood ratio (LR+), negative likelihood ratio (LR−) and diagnostic odds ratio (DOR) with 95% confidence interval (CI) were 87% (84–90%), 90% (88–92%), 6.78 (4.87–9.44), 0.16 (0.13–0.20) and 44.70 (32.34–61.79), respectively. The area under the curve (AUC) was 0.93. The risk of publication bias was negligible (p = 0.75). In conclusion, examination by MRI is able to provide appreciable diagnostic performance. However, the principle, which states that the higher the MFI, the better the diagnostic accuracy, could not be verified. Additionally, conventional sequences (CSs) associated with proton density-weighted imaging (PDWI) are only slightly better than CSs alone, but not statistically different.

Pay Attention to the Imaging Study of Sport Injury and Illness in Winter Olympics Sports

“…Considering the example of ligamentous injury from alpine skiing, a meta-analysis of MRI studies revealed that the sensitivity and specificity of diagnosing ACL injuries using this imaging modality were 87% and 90%, respectively, with an area under the curve of 0.93. [ 14 ] Palmer-Green and Elliott[ 6 ] reported three grades of degree of sports injury in the 2014 Sochi Winter Olympic Games: (1) Time-loss, defined as an injury/illness that prevented an athlete's participation in any training or competition; (2) performance restriction, defined as an injury/illness where training and/or competition participation continued but the volume and/or intensity was restricted as a result of the injury or illness; and (3) medical attention (only), defined as an injury/illness that required medical attention but did not cause time loss or performance restriction. Taking the medical security during the Winter Olympic Games as an example, lower limb muscle strain sustained by speed skating and ice hockey athletes due to high speed is divided into three grades:[ 15 ] (1) Grade I: No obvious strength or mobility limitations, MRI signal is normal or consists of only mildly abnormal muscle signal (edema, hemorrhage, and feathery changes); muscle pain and imaging abnormalities can be restored to normal after proper rest and avoidance of strenuous exercise, (2) Grade II: Muscle tendon hematoma, which often requires conservative treatment (ice compress, physical therapy, and ultrasonic therapy).…”

Dynamic ultrasonography in the diagnosis of acute anterior cruciate ligament injury – a case report

“…Firstly, It can be easily archived. Secondly, measurements of the experience-related (2) . Improvements in imaging technology including sequences, specific knee coils, scanning technique as well as the radiologist's familiarity with MRI over time will result in even greater accuracy (6) .…”

Impact of magnetic resonance imaging on arthroscopic surgeries of knee joint

“…11,12 Precise diagnostic accuracy of MRI for ACL injury is unknown. 13 Ben-Galin et al reported a false-positive rate of 47% for ACL injuries, in comparison with the intraoperative findings. They also stated that 37% of the surgeries done based on MRI were performed unjustifiably.…”