The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis.
OBJECTIVE
Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) have been advocated for the diagnosis of acetabular labral tears. The purpose of this study was to determine the sensitivity and specificity of MRI and MRA in diagnosing acetabular labral tears using meta-analysis.


METHODS
Pertinent published and unpublished literature databases were reviewed. A two-by-two table was constructed to calculate the sensitivity and specificity of MRI or MRA investigations against surgical outcomes. Pooled sensitivity and specificity and Receiver Operating Characteristic curve (ROC) evaluations were performed. Methodological quality of each study was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) tool.


RESULTS
Nineteen papers assessing 881 hips were reviewed. Conventional MRI was assessed in 13 studies and MRA was assessed in 16 studies. Whilst both MRI (0.5-3T) and MRA (0.5-3T) presented with a moderate sensitivity and specificity (sensitivity 66%, 87%; specificity 79%, 64%), diagnostic accuracy of MRA appeared to be superior to MRI in detecting acetabular labral tears on ROC curve interpretation. The literature poorly described population characteristics, assessor blinding, with limited sample sizes.


CONCLUSIONS
MRI and MRA may be useful adjuncts in the diagnosis of acetabular labral tears in adults. MRA appears to be superior to conventional MRI.
Smith
Toby O
TO
Faculty of Health, Queen's Building, University of East Anglia, Norwich NR4 7TJ, United Kingdom. toby.smith@uea.ac.uk
Hilton
Gemma
G
Toms
Andoni P
AP
Donell
Simon T
ST
Hing
Caroline B
CB
D000077:Acetabulum / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001175:Arthrography / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D025981:Hip Injuries / Q000473:pathology* / Q000601:surgery; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011786:Quality Control; D012680:Sensitivity and Specificity; D016896:Treatment Outcome