Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis.
OBJECTIVE
The purpose of this study was to compare the diagnostic accuracy of MRI, MR arthrography, and ultrasound for the diagnosis of rotator cuff tears through a meta-analysis of the studies in the literature.


METHODS
Articles reporting the sensitivities and specificities of MRI, MR arthrography, or ultrasound for the diagnosis of rotator cuff tears were identified. Surgical (open and arthroscopic) reference standard was an inclusion criterion. Summary statistics were generated using pooled data. Scatterplots of the data sets were plotted on a graph of sensitivity versus (1 - specificity). Receiver operating characteristic (ROC) curves were generated.


RESULTS
Sixty-five articles met the inclusion criteria for this meta-analysis. In diagnosing a full-thickness tear or a partial-thickness rotator cuff tear, MR arthrography is more sensitive and specific than either MRI or ultrasound (p < 0.05). There are no significant differences in either sensitivity or specificity between MRI and ultrasound in the diagnosis of partial- or full-thickness rotator cuff tears (p > 0.05). Summary ROC curves for MR arthrography, MRI, and ultrasound for all tears show the area under the ROC curve is greatest for MR arthrography (0.935), followed by ultrasound (0.889) and then MRI (0.878); however, pairwise comparisons of these curves show no significant differences between MRI and ultrasound (p > 0.05).


CONCLUSIONS
MR arthrography is the most sensitive and specific technique for diagnosing both full- and partial-thickness rotator cuff tears. Ultrasound and MRI are comparable in both sensitivity and specificity.
de Jesus
Joseph O
JO
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244, USA.
Parker
Laurence
L
Frangos
Andrea J
AJ
Nazarian
Levon N
LN
D001175:Arthrography / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000175:diagnosis / Q000453:epidemiology; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000706:statistics & numerical data*