The diagnostic value of magnetic resonance imaging for assessing acetabular labral tears: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XU Yongsheng ^1,2,3 , LIU Haifeng ^1,2,3 , WANG Yinzhong ¹ , GAO Yuling ^1,2 , TIAN Shuishui ^1,2 , TIAN Jinhui ³ , YANG Kehu ³ ,  LEI Junqiang ¹

1. Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R. China;
2. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R. China;
3. EBM Center of Lanzhou University, Lanzhou, 730000, P.R. China;

Corresponding?author：

LEI Junqiang, Email: leijq1990@163.com

Keywords：

Magnetic resonance imaging; Magnetic resonance artlrography; Hip joint; Labrum; Damage; Diagnosis; Meta-analysis

DOI：

10.7507/1672-2531.201611079

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the values of magnetic resonance imaging (MRI) in the diagnosis of acetabular labral tears (ALT) by meta-analysis. Methods The studies concerning the diagnosis of ALT tears by using MRI from January 1990 to October 2016 were searched in the databases such as CBM, VIP, WanFang Data, CNKI, PubMed, EMbase, The Cochrane Library and Web of Science. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then, meta-analysis was performed by using Stata 12.0 software. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (–LR) and the diagnostic odds ratio (DOR) were calculated, and the summary receiver operating characteristic curve (SROC) was drawn and the area under the carve was calculated. Results A total of 25 studies from 21 articles were included, involving 1 123 hips from 1 099 patients. The results of meta-analysis showed that, the pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRI for diagnosing ALT were 0.66 (95% CI 0.38 to 0.86), 0.72 (95% CI 0.47 to 0.89), 2.37 (95% CI 1.18 to 4.67), 0.48 (95% CI 0.25 to 0.92), 4.97 (95% CI 1.60 to 15.47), 0.75 (95% CI 0.71 to 0.79). The pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRA for diagnosing ALT were 0.86 (95% CI 0.80 to 0.90), 0.71 (95% CI 0.55 to 0.83), 2.91 (95% CI 1.77 to 4.80), 0.20 (95% CI 0.13 to 0.32), 14.44 (95% CI 5.80 to 35.95), 0.87 (95% CI 0.84 to 0.90), respectively. Conclusion MRI is efficiency diagnostic method for acetabular labral tears.

Citation： XU Yongsheng, LIU Haifeng, WANG Yinzhong, GAO Yuling, TIAN Shuishui, TIAN Jinhui, YANG Kehu, LEI Junqiang. The diagnostic value of magnetic resonance imaging for assessing acetabular labral tears: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(3): 291-297. doi: 10.7507/1672-2531.201611079 Copy

1.	?Chahla J, Soares E, Bhatia S, et al. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft. Arthrosc Tech, 2016, 5(3): e671-677.
2.	Petersen BD, Wolf B, Lambert JR, et al. Lateral acetabular labral length is inversely related to acetabular coverage as measured by lateral center edge angle of Wiberg. J Hip Preserv Surg, 2016, 3(3): 190-196.
3.	Dwyer MK, Lewis CL, Hanmer AW, et al. Do Neuromuscular Alterations Exist for Patients With Acetabular Labral Tears During Function? Arthroscopy, 2016, 32(6): 1045-1052.
4.	Jayakar R, Merz A, Plotkin B, et al. Magnetic resonance arthrography and the prevalence of acetabular labral tears in patients 50 years of age and older. Skeletal Radiol, 2016, 45(8): 1061-1067.
5.	Lee AJ, Armour P, Thind D, et al. The prevalence of acetabular labral tears and associated pathology in a young asymptomatic population. Bone Joint J, 2015, 97-b(5): 623-627.
6.	Bozic KJ, Chan V, Valone FH, et al. Trends in hip arthroscopy utilization in the United States. J Arthroplasty, 2013, 28(8 Suppl): 140-143.
7.	Weber AE, Harris JD, Nho SJ. Complications in Hip Arthroscopy: A Systematic Review and Strategies for Prevention. Sports Med Arthrosc, 2015, 23(4): 187-193.
8.	Aprato A, Jayasekera N, Villar RN. The accuracy of magnetic resonance arthrography in hip arthroscopic labral revision surgery. Hip Inter, 2013, 23(1): 99-103.
9.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann In Med, 2011, 155(8): 529-536.
10.	Banks DB, Boden RA, Mehan R, et al. Magnetic resonance arthrography for labral tears and chondral wear in femoroacetabular impingement. Hip Inter, 2012, 22(4): 387-390.
11.	Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med, 2004, 32(7): 1668-1674.
12.	Czerny C, Hofmann S, Neuhold A, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology, 1996, 200(1): 225-230.
13.	Czerny C, Hofmann S, Urban M, et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol, 1999, 173(2): 345-349.
14.	Keeney JA, Peelle MW, Jackson J, et al. Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res, 2004, (429): 163-169.
15.	Leunig M, Werlen S, Ungersbock A, et al. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Am, 1997, 79(2): 230-234.
16.	McCarthy JC, Glassner PJ. Correlation of magnetic resonance arthrography with revision hip arthroscopy. Clin Orthop Relat Res, 2013, 471(12): 4006-4011.
17.	Mintz DN, Hooper T, Connell D, et al. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast im aging. Arthroscopy, 2005, 21(4): 385-393.
18.	Nishii T, Nakanishi K, Sugano N, et al. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction. Skeletal Radiol, 1996, 25(4): 349-356.
19.	Petersilge CA, Haque MA, Petersilge WJ, et al. Acetabular labral tears: evaluation with MR arthrography. Radiology, 1996, 200(1): 231-235.
20.	Reurink G, Jansen SP, Bisselink JM, et al. Reliability and validity of diagnosing acetabular labral lesions with magnetic resonance arthrography. J Bone Joint Surg Am, 2012, 94(18): 1643-1648.
21.	Saddik D, Tran P, Troupis J, et al. Are extra-labral MR findings useful in the diagnosis of a labral tear? J Med Imaging Radiat Oncol, 2012, 56(3): 255-260.
22.	Schmid MR, Notzli HP, Zanetti M, et al. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology, 2003, 226(2): 382-386.
23.	Studler U, Kalberer F, Leunig M, et al. MR arthrography of the hip: differentiation between an anterior sublabral recess as a normal variant and a labral tear. Radiology, 2008, 249(3): 947-954.
24.	Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology, 2006, 238(2): 706-711.
25.	Sutter R, Zubler V, Hoffmann A, et al. Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol, 2014, 202(1): 160-169.
26.	Tian CY, Wang JQ, Zheng ZZ, et al. 3.0T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy. Eur J Radiol, 2014, 83(10): 1822-1827.
27.	Toomayan GA, Holman WR, Major NM, et al. Sensitivity of MR arthrography in the evaluation of acetabular labral tears. AJR Am J Roentgenol, 2006, 186(2): 449-453.
28.	Zlatkin MB, Pevsner D, Sanders TG, et al. Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy--a preliminary study. AJR Am J Roentgenol, 2010, 194(3): 709-714.
29.	洪聞, 張雪哲, 王武, 等. 髖關節 MR 造影在髖臼唇撕裂診斷中的應用. 中華放射學雜志, 2010, 44(11): 1140-1143.
30.	田春艷, 袁慧書, 王健全. 單側髖高分辨 3.0T MRI 對臼唇撕裂的診斷. 影像診斷與介入放射學, 2016, 25(2): 138-141.
31.	Mayes S, Ferris AR, Smith P, et al. Similar Prevalence of Acetabular Labral Tear in Professional Ballet Dancers and Sporting Participants. Clinical journal of sport medicine, 2016, 26(4): 307-313.
32.	Ha YC, Choi JA, Lee YK, et al. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation. Skeletal radiology, 2013, 42(5): 681-688.
33.	Park SY, Park JS, Jin W, et al. Diagnosis of acetabular labral tears: comparison of three-dimensional intermediate-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography at 3.0 T. Acta Radiologica, 2013, 54(1): 75-82.
34.	李幼平, 李靜, 孫鑫, 等. 循證醫學在中國的發展: 回顧與展望. 蘭州大學學報(醫學版), 2016, 42(1): 25-28.
35.	田金徽, 陳耀龍, 楊克虎, 等. SR/MA 研究進展與挑戰. 蘭州大學學報(醫學版), 2016, 42(1): 42-47.
36.	Guyatt GH, Oxman AD, Montori V, 等. GRADE 指南:Ⅴ.證據質量評價—發表偏倚. 中國循證醫學雜志, 2011, 11(12): 1430-1434.
37.	Tackmann R, Schuetz G, Hamm B, et al. Quality of the reporting of diagnostic accuracy studies: STARD (Standards for the Reporting of Diagnostic accuracy studies). RoFo, 2010, 182(8): 655-659.
38.	Smith TO, Hilton G, Toms AP, et al. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol, 2011, 21(4): 863-874.
39.	Smith TO, Simpson M, Ejindu V, et al. The diagnostic test accuracy of magnetic resonance imaging, magnetic resonance arthrography and computer tomography in the detection of chondral lesions of the hip. Eur J Orthop Surg Traumatol, 2013, 23(3): 335-344.
40.	雷軍強, 馬文婷, 王寅中, 等. 特異性肝膽對比劑釓塞酸二鈉對肝轉移瘤的診斷價值的Meta分析. 中國循證醫學雜志, 2015, 15(12): 1378-1386.
41.	Rhodes KM, Turner RM, White IR, et al. Implementing informative priors for heterogeneity in meta-analysis using meta-regression and pseudo data. Stat Med, 2016, 35(29): 5495-5511.

1. ?Chahla J, Soares E, Bhatia S, et al. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft. Arthrosc Tech, 2016, 5(3): e671-677.
2. Petersen BD, Wolf B, Lambert JR, et al. Lateral acetabular labral length is inversely related to acetabular coverage as measured by lateral center edge angle of Wiberg. J Hip Preserv Surg, 2016, 3(3): 190-196.
3. Dwyer MK, Lewis CL, Hanmer AW, et al. Do Neuromuscular Alterations Exist for Patients With Acetabular Labral Tears During Function? Arthroscopy, 2016, 32(6): 1045-1052.
4. Jayakar R, Merz A, Plotkin B, et al. Magnetic resonance arthrography and the prevalence of acetabular labral tears in patients 50 years of age and older. Skeletal Radiol, 2016, 45(8): 1061-1067.
5. Lee AJ, Armour P, Thind D, et al. The prevalence of acetabular labral tears and associated pathology in a young asymptomatic population. Bone Joint J, 2015, 97-b(5): 623-627.
6. Bozic KJ, Chan V, Valone FH, et al. Trends in hip arthroscopy utilization in the United States. J Arthroplasty, 2013, 28(8 Suppl): 140-143.
7. Weber AE, Harris JD, Nho SJ. Complications in Hip Arthroscopy: A Systematic Review and Strategies for Prevention. Sports Med Arthrosc, 2015, 23(4): 187-193.
8. Aprato A, Jayasekera N, Villar RN. The accuracy of magnetic resonance arthrography in hip arthroscopic labral revision surgery. Hip Inter, 2013, 23(1): 99-103.
9. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann In Med, 2011, 155(8): 529-536.
10. Banks DB, Boden RA, Mehan R, et al. Magnetic resonance arthrography for labral tears and chondral wear in femoroacetabular impingement. Hip Inter, 2012, 22(4): 387-390.
11. Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med, 2004, 32(7): 1668-1674.
12. Czerny C, Hofmann S, Neuhold A, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology, 1996, 200(1): 225-230.
13. Czerny C, Hofmann S, Urban M, et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol, 1999, 173(2): 345-349.
14. Keeney JA, Peelle MW, Jackson J, et al. Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res, 2004, (429): 163-169.
15. Leunig M, Werlen S, Ungersbock A, et al. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Am, 1997, 79(2): 230-234.
16. McCarthy JC, Glassner PJ. Correlation of magnetic resonance arthrography with revision hip arthroscopy. Clin Orthop Relat Res, 2013, 471(12): 4006-4011.
17. Mintz DN, Hooper T, Connell D, et al. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast im aging. Arthroscopy, 2005, 21(4): 385-393.
18. Nishii T, Nakanishi K, Sugano N, et al. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction. Skeletal Radiol, 1996, 25(4): 349-356.
19. Petersilge CA, Haque MA, Petersilge WJ, et al. Acetabular labral tears: evaluation with MR arthrography. Radiology, 1996, 200(1): 231-235.
20. Reurink G, Jansen SP, Bisselink JM, et al. Reliability and validity of diagnosing acetabular labral lesions with magnetic resonance arthrography. J Bone Joint Surg Am, 2012, 94(18): 1643-1648.
21. Saddik D, Tran P, Troupis J, et al. Are extra-labral MR findings useful in the diagnosis of a labral tear? J Med Imaging Radiat Oncol, 2012, 56(3): 255-260.
22. Schmid MR, Notzli HP, Zanetti M, et al. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology, 2003, 226(2): 382-386.
23. Studler U, Kalberer F, Leunig M, et al. MR arthrography of the hip: differentiation between an anterior sublabral recess as a normal variant and a labral tear. Radiology, 2008, 249(3): 947-954.
24. Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology, 2006, 238(2): 706-711.
25. Sutter R, Zubler V, Hoffmann A, et al. Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol, 2014, 202(1): 160-169.
26. Tian CY, Wang JQ, Zheng ZZ, et al. 3.0T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy. Eur J Radiol, 2014, 83(10): 1822-1827.
27. Toomayan GA, Holman WR, Major NM, et al. Sensitivity of MR arthrography in the evaluation of acetabular labral tears. AJR Am J Roentgenol, 2006, 186(2): 449-453.
28. Zlatkin MB, Pevsner D, Sanders TG, et al. Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy--a preliminary study. AJR Am J Roentgenol, 2010, 194(3): 709-714.
29. 洪聞, 張雪哲, 王武, 等. 髖關節 MR 造影在髖臼唇撕裂診斷中的應用. 中華放射學雜志, 2010, 44(11): 1140-1143.
30. 田春艷, 袁慧書, 王健全. 單側髖高分辨 3.0T MRI 對臼唇撕裂的診斷. 影像診斷與介入放射學, 2016, 25(2): 138-141.
31. Mayes S, Ferris AR, Smith P, et al. Similar Prevalence of Acetabular Labral Tear in Professional Ballet Dancers and Sporting Participants. Clinical journal of sport medicine, 2016, 26(4): 307-313.
32. Ha YC, Choi JA, Lee YK, et al. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation. Skeletal radiology, 2013, 42(5): 681-688.
33. Park SY, Park JS, Jin W, et al. Diagnosis of acetabular labral tears: comparison of three-dimensional intermediate-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography at 3.0 T. Acta Radiologica, 2013, 54(1): 75-82.
34. 李幼平, 李靜, 孫鑫, 等. 循證醫學在中國的發展: 回顧與展望. 蘭州大學學報(醫學版), 2016, 42(1): 25-28.
35. 田金徽, 陳耀龍, 楊克虎, 等. SR/MA 研究進展與挑戰. 蘭州大學學報(醫學版), 2016, 42(1): 42-47.
36. Guyatt GH, Oxman AD, Montori V, 等. GRADE 指南:Ⅴ.證據質量評價—發表偏倚. 中國循證醫學雜志, 2011, 11(12): 1430-1434.
37. Tackmann R, Schuetz G, Hamm B, et al. Quality of the reporting of diagnostic accuracy studies: STARD (Standards for the Reporting of Diagnostic accuracy studies). RoFo, 2010, 182(8): 655-659.
38. Smith TO, Hilton G, Toms AP, et al. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol, 2011, 21(4): 863-874.
39. Smith TO, Simpson M, Ejindu V, et al. The diagnostic test accuracy of magnetic resonance imaging, magnetic resonance arthrography and computer tomography in the detection of chondral lesions of the hip. Eur J Orthop Surg Traumatol, 2013, 23(3): 335-344.
40. 雷軍強, 馬文婷, 王寅中, 等. 特異性肝膽對比劑釓塞酸二鈉對肝轉移瘤的診斷價值的Meta分析. 中國循證醫學雜志, 2015, 15(12): 1378-1386.
41. Rhodes KM, Turner RM, White IR, et al. Implementing informative priors for heterogeneity in meta-analysis using meta-regression and pseudo data. Stat Med, 2016, 35(29): 5495-5511.

Chinese Journal of Evidence-Based Medicine

The diagnostic value of magnetic resonance imaging for assessing acetabular labral tears: a meta-analysis

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