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J Knee Surg 2021; 34(02): 121-129
DOI: 10.1055/s-0039-1694056
Original Article

Accuracy of MRI Diagnosis of Meniscal Tears of the Knee: A Meta-Analysis and Systematic Review

Wei Wang
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Zheng Li
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Hui-Ming Peng
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Yan-Yan Bian
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Ye Li
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Wen-Wei Qian
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Xi-Sheng Weng
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Jin Jin
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Xin-Yu Yang
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Jin Lin
1   Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People's Republic of China
› Author Affiliations Funding This study was supported by 2015–2016 Post-graduated Education Reform Foundation (Grant No. PUMC-GS-2015004 and PUMC-GS-2015005) and 2015 Small-Scale Characteristic Education Foundation (Grant No. 2015zlgc0122).
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Abstract

This study aimed to evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in patients with suspected meniscal tears. PubMed, Cochrane, Embase database updated to November 2017 were searched by the index words to identify qualified studies, including prospective cohort studies and cross-sectional studies. Literature was also identified by tracking using reference lists. Heterogeneity of the included studies was reviewed to select proper effects model for pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were performed for meniscal tears. A total of 17 studies were involved in this meta-analysis to explore the diagnostic accuracy of MRI for meniscal tears. The global sensitivity and specificity of MRI of meniscal tears were 92.0% (95% confidence interval [CI]: 88.0–95.0%) and 90.0% (95% CI: 85.0–95.0%) in medial meniscal tears, and 80.0% (95% CI: 66.0–89.0%) and 95.0% (95% CI: 91.0–97.0%) in lateral meniscal tears, respectively. Moreover, the global positive and negative likelihood ratio of MRI of meniscal tears were 10.33 (95% CI: 6.04–17.67) and 0.09 (95% CI: 0.05–0.14) in medial meniscal tears; 16.48 (95% CI: 8.81–30.83) and 0.21 (95% CI: 0.12–0.37) in lateral meniscal tears, respectively. The global DOR was 81.69 (95% CI: 37.94–175.91) in medial meniscal tears and 56.59 (95% CI: 22.51–142.28) in lateral meniscal tears. The results of area under the SROC indicated high accuracy in medial meniscal tears (area under the curve [AUC] = 0.97, 95% CI: 0.95–0.98) and lateral meniscal tears (AUC = 0.96, 95% CI: 0.94–0.97). This review presents a systematic review and meta-analysis to evaluate the diagnostic accuracy of MRI of meniscal tears. Moderate-to-strong evidence suggests that MRI appears to be associated with higher diagnostic accuracy for detecting medial and lateral meniscal tears.

Keywords

meta-analysis - meniscal tear - magnetic resonance imaging - diagnostic accuracy


Publication History

Received: 13 February 2018

Accepted: 18 June 2019

Article published online:
07 August 2019

© 2019. Thieme. All rights reserved.

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  • References

  • 1 Adalberth T, Roos H, Laurén M. et al. Magnetic resonance imaging, scintigraphy, and arthroscopic evaluation of traumatic hemarthrosis of the knee. Am J Sports Med 1997; 25 (02) 231-237
    CrossrefPubMedSearch in Google Scholar
  • 2 Ducouret E, Loriaut P, Boyer P. et al. Tunnel positioning assessment after anterior cruciate ligament reconstruction at 12 months: comparison between 3D CT and 3D MRI. A pilot study. Orthop Traumatol Surg Res 2017; 103 (06) 937-942
    CrossrefPubMedSearch in Google Scholar
  • 3 Felisaz PF, Alessandrino F, Perelli S. et al. Role of MRI in predicting meniscal tear reparability. Skeletal Radiol 2017; 46 (10) 1343-1351
    CrossrefPubMedSearch in Google Scholar
  • 4 Abdulaal OM, Rainford L, MacMahon P. et al. 3T MRI of the knee with optimised isotropic 3D sequences: Accurate delineation of intra-articular pathology without prolonged acquisition times. Eur Radiol 2017; 27 (11) 4563-4570
    CrossrefPubMedSearch in Google Scholar
  • 5 Derby E, Imrecke J, Henckel J, Hirschmann A, Amsler F, Hirschmann MT. How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?. Knee Surg Sports Traumatol Arthrosc 2017; 25 (02) 517-523
    CrossrefPubMedSearch in Google Scholar
  • 6 Nebelung S, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D. Ex vivo quantitative multiparametric MRI mapping of human meniscus degeneration. Skeletal Radiol 2016; 45 (12) 1649-1660
    CrossrefPubMedSearch in Google Scholar
  • 7 Harner CD, Mauro CS, Lesniak BP, Romanowski JR. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Surgical technique. J Bone Joint Surg Am 2009; 91 (Suppl. 02) 257-270
    CrossrefPubMedSearch in Google Scholar
  • 8 Jones RS, Keene GC, Learmonth DJ. et al. Direct measurement of hoop strains in the intact and torn human medial meniscus. Clin Biomech (Bristol, Avon) 1996; 11 (05) 295-300
    CrossrefPubMedSearch in Google Scholar
  • 9 Magee T, Shapiro M, Williams D. MR accuracy and arthroscopic incidence of meniscal radial tears. Skeletal Radiol 2002; 31 (12) 686-689
    CrossrefPubMedSearch in Google Scholar
  • 10 Kam CK, Chee DW, Peh WC. Magnetic resonance imaging of cruciate ligament injuries of the knee. Can Assoc Radiol J 2010; 61 (02) 80-89
    CrossrefPubMedSearch in Google Scholar
  • 11 Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Br Med Bull 2007; 84: 5-23
    CrossrefPubMedSearch in Google Scholar
  • 12 Alizadeh A, Babaei Jandaghi A, Keshavarz Zirak A, Karimi A, Mardani-Kivi M, Rajabzadeh A. Knee sonography as a diagnostic test for medial meniscal tears in young patients. Eur J Orthop Surg Traumatol 2013; 23 (08) 927-931
    CrossrefPubMedSearch in Google Scholar
  • 13 Arif U, Shah ZA, Khan MA, Ijaz M, Qayum H. Diagnostic accuracy of 1.5 tesla MRI in the diagnosis of meniscal tears of knee joint. Pak J Med Health Sci 2013; 7 (01) 227-230
    PubMedSearch in Google Scholar
  • 14 Franklin PD, Lemon RA, Barden HS. Accuracy of imaging the menisci on an in-office, dedicated, magnetic resonance imaging extremity system. Am J Sports Med 1997; 25 (03) 382-388
    CrossrefPubMedSearch in Google Scholar
  • 15 Yoon JW, Kim KW, Kim HM, Pak CY, Kim YW, McArthur RG. Coxsackie B virus assays in IDDM families: the GAW5 data on antibody prevalence. Genet Epidemiol 1989; 6 (01) 35-37
    CrossrefPubMedSearch in Google Scholar
  • 16 Esmaili Jah AA, Keyhani S, Zarei R, Moghaddam AK. Accuracy of MRI in comparison with clinical and arthroscopic findings in ligamentous and meniscal injuries of the knee. Acta Orthop Belg 2005; 71 (02) 189-196
    PubMedSearch in Google Scholar
  • 17 Khan Z, Faruqui Z, Ogyunbiyi O, Rosset G, Iqbal J. Ultrasound assessment of internal derangement of the knee. Acta Orthop Belg 2006; 72 (01) 72-76
    PubMedSearch in Google Scholar
  • 18 Kinnunen J, Bondestam S, Kivioja A. et al. Diagnostic performance of low field MRI in acute knee injuries. Magn Reson Imaging 1994; 12 (08) 1155-1160
    CrossrefPubMedSearch in Google Scholar
  • 19 Miller GK. A prospective study comparing the accuracy of the clinical diagnosis of meniscus tear with magnetic resonance imaging and its effect on clinical outcome. Arthroscopy 1996; 12 (04) 406-413
    CrossrefPubMedSearch in Google Scholar
  • 20 Munshi M, Davidson M, MacDonald PB, Froese W, Sutherland K. The efficacy of magnetic resonance imaging in acute knee injuries. Clin J Sport Med 2000; 10 (01) 34-39
    CrossrefPubMedSearch in Google Scholar
  • 21 Rappeport ED, Wieslander SB, Stephensen S, Lausten GS, Thomsen HS. MRI preferable to diagnostic arthroscopy in knee joint injuries. A double-blind comparison of 47 patients. Acta Orthop Scand 1997; 68 (03) 277-281
    CrossrefPubMedSearch in Google Scholar
  • 22 von Engelhardt LV, Schmitz A, Pennekamp PH, Schild HH, Wirtz DC, von Falkenhausen F. Diagnostics of degenerative meniscal tears at 3-Tesla MRI compared to arthroscopy as reference standard. Arch Orthop Trauma Surg 2008; 128 (05) 451-456
    CrossrefPubMedSearch in Google Scholar
  • 23 Bürk J, Vicari M, Dovi-Akué P. et al. Extremity-dedicated low-field MRI shows good diagnostic accuracy and interobserver agreement for the diagnosis of the acutely injured knee. Clin Imaging 2015; 39 (05) 871-875
    CrossrefPubMedSearch in Google Scholar
  • 24 Felli L, Garlaschi G, Muda A. et al. Comparison of clinical, MRI and arthroscopic assessments of chronic ACL injuries, meniscal tears and cartilage defects. Musculoskelet Surg 2016; 100 (03) 231-238
    CrossrefPubMedSearch in Google Scholar
  • 25 Dufka FL, Lansdown DA, Zhang AL, Allen CR, Ma CB, Feeley BT. Accuracy of MRI evaluation of meniscus tears in the setting of ACL injuries. Knee 2016; 23 (03) 460-464
    CrossrefPubMedSearch in Google Scholar
  • 26 Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of magnetic resonance imaging in assessment of meniscal and ACL tear: correlation with arthroscopy. Pak J Med Sci 2015; 31 (02) 263-268
    CrossrefPubMedSearch in Google Scholar
  • 27 Parkkinen M, Madanat R, Mäkinen TJ, Mustonen A, Koskinen SK, Lindahl J. The usefulness of MRI and arthroscopy in the diagnosis and treatment of soft-tissue injuries associated with split-depression fractures of the lateral tibial condyle. Bone Joint J 2014; 96-B (12) 1631-1636
    CrossrefPubMedSearch in Google Scholar
  • 28 Lee JH, Yoon YC, Park KJ, Wang JH. Diagnosis of internal derangement of the knee: volume isotropic turbo spin-echo acquisition MRI with fat suppression versus without fat suppression. AJR Am J Roentgenol 2017; 208 (06) 1304-1311
    CrossrefPubMedSearch in Google Scholar
  • 29 Patadia MO, Welch KC. Role of immunotherapy in allergic fungal rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2015; 23 (01) 21-28
    CrossrefPubMedSearch in Google Scholar
  • 30 Smith C, McGarvey C, Harb Z. et al. Diagnostic efficacy of 3-T MRI for knee injuries using arthroscopy as a reference standard: a meta-analysis. AJR Am J Roentgenol 2016; 207 (02) 369-377
    CrossrefPubMedSearch in Google Scholar
  • 31 Liu XS, Xu JR, Hua J, Wang BS. MRI diagnosis in meniscal tears: a meta-analysis. Zhonghua Fang She Xue Za Zhi 2007; 41 (07) 731-736
    PubMedSearch in Google Scholar