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Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis

Ahmed Saied UGent, CAROLINE REDANT, M El-Batouty, MR El-Lakkany, WA El-Adl, Joris Anthonissen, René Verdonk and Emmanuel Audenaert UGent (2017) BMC MUSCULOSKELETAL DISORDERS. 18.
abstract
Background: Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). Methods: A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. Results: The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. Conclusions: The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are obtained concerning iMRA but further studies still needed to fully assess its diagnostic accuracy.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Magnetic resonance, Hip joint, Labral lesion, Chondral lesion, Cartilage defect, Sensitivity, Specificity, Femoroacetabular impingement, ACETABULAR CARTILAGE DELAMINATION, INDIRECT MR ARTHROGRAPHY, DIAGNOSTIC-ACCURACY, ARTICULAR-CARTILAGE, HIP, TEARS, CAM, PREVALENCE, ABNORMALITIES, ARTHROSCOPY
journal title
BMC MUSCULOSKELETAL DISORDERS
BMC Musculoskelet. Disord.
volume
18
article number
83
pages
16 pages
Web of Science type
Article
Web of Science id
000395205700001
ISSN
1471-2474
DOI
10.1186/s12891-017-1443-2
language
English
UGent publication?
yes
classification
A1
copyright statement
Creative Commons Attribution 4.0 International Public License (CC-BY 4.0)
id
8514925
handle
http://hdl.handle.net/1854/LU-8514925
date created
2017-03-20 15:37:52
date last changed
2017-04-12 14:02:54
@article{8514925,
  abstract     = {Background: Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). 
Methods: A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95\% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. 
Results: The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. 
Conclusions: The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are obtained concerning iMRA but further studies still needed to fully assess its diagnostic accuracy.},
  articleno    = {83},
  author       = {Saied, Ahmed and REDANT, CAROLINE and El-Batouty, M and El-Lakkany, MR and El-Adl, WA and Anthonissen, Joris and Verdonk, Ren{\'e} and Audenaert, Emmanuel},
  issn         = {1471-2474},
  journal      = {BMC MUSCULOSKELETAL DISORDERS},
  keyword      = {Magnetic resonance,Hip joint,Labral lesion,Chondral lesion,Cartilage defect,Sensitivity,Specificity,Femoroacetabular impingement,ACETABULAR CARTILAGE DELAMINATION,INDIRECT MR ARTHROGRAPHY,DIAGNOSTIC-ACCURACY,ARTICULAR-CARTILAGE,HIP,TEARS,CAM,PREVALENCE,ABNORMALITIES,ARTHROSCOPY},
  language     = {eng},
  pages        = {16},
  title        = {Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis},
  url          = {http://dx.doi.org/10.1186/s12891-017-1443-2},
  volume       = {18},
  year         = {2017},
}

Chicago
Saied, Ahmed, CAROLINE REDANT, M El-Batouty, MR El-Lakkany, WA El-Adl, Joris Anthonissen, René Verdonk, and Emmanuel Audenaert. 2017. “Accuracy of Magnetic Resonance Studies in the Detection of Chondral and Labral Lesions in Femoroacetabular Impingement : Systematic Review and Meta-analysis.” Bmc Musculoskeletal Disorders 18.
APA
Saied, A., REDANT, C., El-Batouty, M., El-Lakkany, M., El-Adl, W., Anthonissen, J., Verdonk, R., et al. (2017). Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis. BMC MUSCULOSKELETAL DISORDERS, 18.
Vancouver
1.
Saied A, REDANT C, El-Batouty M, El-Lakkany M, El-Adl W, Anthonissen J, et al. Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis. BMC MUSCULOSKELETAL DISORDERS. 2017;18.
MLA
Saied, Ahmed, CAROLINE REDANT, M El-Batouty, et al. “Accuracy of Magnetic Resonance Studies in the Detection of Chondral and Labral Lesions in Femoroacetabular Impingement : Systematic Review and Meta-analysis.” BMC MUSCULOSKELETAL DISORDERS 18 (2017): n. pag. Print.