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Evidence-based Practice |
1 From the Program for the Assessment of Radiological Technology, Departments of Radiology (E.H.G.O., J.J.N., A.C.M.V., A.Z.G., M.G.M.H.) and Epidemiology and Biostatistics (E.H.G.O., J.J.N., A.C.M.V., M.G.M.H.), Erasmus University Medical Center Rotterdam, Dr Molewaterplein 50, Rm EE21-40a, 3015 GE Rotterdam, the Netherlands. From the 2001 RSNA scientific assembly. Received November 26, 2001; revision requested February 5, 2002; final revision received June 26; accepted July 16. Supported in part by the Foundation "Vereniging Trustfonds Erasmus Universiteit Rotterdam," the Foundation "Gerrit Jan Mulder Stichting," and the "Revolving Fund" of the University Hospital Rotterdam. Address correspondence to M.G.M.H. (e-mail: hunink@epib.fgg.eur.nl).
PURPOSE: To systematically review and synthesize published data on the diagnostic performance of magnetic resonance (MR) imaging of the menisci and cruciate ligaments and to assess the effect of study design characteristics and magnetic field strength on diagnostic performance.
MATERIALS AND METHODS: Articles published between 1991 and 2000 were included if at least 30 patients were studied, arthroscopy was the reference standard, the magnetic field strength was reported, positivity criteria were defined, and the absolute numbers of true-positive, false-negative, true-negative, and false-positive results were available or derivable. Pooled weighted and summary receiver operating characteristic (ROC) analyses were performed for tears of both menisci and both cruciate ligaments separately and for the four lesions combined, by using random effects models. Differences were assessed according to lesion type.
RESULTS: Twenty-nine of 120 retrieved articles were included. Pooled weighted sensitivity was higher for medial meniscal tears than that for lateral meniscal tears. However, pooled weighted specificity for the medial meniscus was lower than that for the lateral meniscus. In summary ROC analyses performed per lesion, various study design characteristics were found to influence diagnostic performance. Higher magnetic field strength significantly improved discriminatory power only for anterior cruciate ligament tears. When all lesions were combined in one overall summary ROC analysis, magnetic field strength was a significant but modest predictor of diagnostic performance.
CONCLUSION: Diagnostic performance of MR imaging of the knee is different according to lesion type and is influenced by various study design characteristics. Higher magnetic field strength modestly improves diagnostic performance, but a significant effect was demonstrated only for anterior cruciate ligament tears.
Supplemental material: radiology.rsnajnls.org/cgi/content/full/2263011892/DC1.
© RSNA, 2003
Index terms: Knee, injuries, 452.485 • Knee, ligaments, menisci, and cartilage, 452.485 • Knee, MR, 452.121419 • Magnetic resonance (MR), technology
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