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Comparison between 3D isotropic and 2D conventional MR arthrography for diagnosing rotator cuff tear and labral lesions: A meta‐analysis
Author(s) -
Lee Sun Hwa,
Yun Seong Jong,
Jin Wook,
Park So Young,
Park Ji Seon,
Ryu Kyung Nam
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26024
Subject(s) - medicine , rotator cuff , receiver operating characteristic , radiology , magnetic resonance imaging , meta analysis , nuclear medicine , pathology
Background Although 3D‐isotropic MR arthrography has been characterized as a substitute imaging tool for rotator cuff tear (RCT) and labral lesions, it has not been commonly used in clinical practice because of controversy related to image blurring and indistinctness of structural edges. Purpose To perform a comparison of the diagnostic performance of 3D‐isotropic MR arthrography and 2D‐conventional MR arthrography for diagnosis of RCT (solely RCT, full/partial‐thickness supraspinatus [SST]‐infraspinatus [IST] tear, or subscapularis [SSc] tear) and labral lesions. Study Type Meta‐analysis. Population Patients with shoulder pain. Field Strength/Sequence 3D‐isotropic and 2D‐conventional MR arthrography at 3.0T or 1.5T. Assessment PubMed and EMBASE were searched following the PRISMA guidelines. Statistical Tests Bivariate modeling and hierarchical summary receiver operating characteristic modeling were performed to compare the overall diagnostic performance of 3D‐isotropic and 2D‐conventional MR arthrography. Multiple‐subgroup analyses were performed for diagnosing RCT, full/partial‐thickness SST‐IST tear, SSc tear, and labral lesions. Meta‐regression analyses were performed according to subject, study, and MR arthrography characteristics including 3D‐isotropic sequences (turbo spine echo [TSE] vs. gradient echo [GRE]). Results Eleven studies (825 patients) were included. Overall, 3D‐isotropic MR arthrography had similar pooled sensitivity (0.90 [95% CI, 0.87–0.93]) ( P = 0.95) and specificity (0.92 [95% CI, 0.87–0.95]) ( P = 0.99), relative to 2D‐conventional MR arthrography (sensitivity, 0.91 [95% CI, 0.86–0.94]); specificity, 0.92 [95% CI, 0.87–0.95]). Multiple‐subgroup analyses showed that sensitivities ( P = 0.13–0.91) and specificities ( P = 0.26–0.99) on 3D‐isotropic MR arthrography for diagnosing RCT, full/partial‐thickness SST‐IST tear, SSC tear, and labral lesions were not significantly different from 2D‐conventional MR arthrography. On meta‐regression analysis, 3D‐TSE sequence demonstrated higher sensitivity ( P < 0.01) than 3D‐GRE for RCT and labral lesions. Data Conclusion 3D‐isotropic MR arthrography can replace 2D‐conventional MR arthrography. 3D‐isotropic MR arthrography using TSE sequence is recommended for more accurate diagnosis, as it demonstrates increased sensitivity. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1034–1045.