Scapholunate Interosseous Ligament Tears: Diagnostic Performance of 1.5 T, 3 T MRI, and MR Arthrography-A Systematic Review and Meta-analysis

Nima Hafezi-Nejad; John A Carrino; John Eng; Craig Blackmore; Jaimie Shores; Scott D Lifchez; Sahar Jalali Farahani; Shadpour Demehri

doi:10.1016/j.acra.2016.04.006

Scapholunate Interosseous Ligament Tears: Diagnostic Performance of 1.5 T, 3 T MRI, and MR Arthrography-A Systematic Review and Meta-analysis

Acad Radiol. 2016 Sep;23(9):1091-103. doi: 10.1016/j.acra.2016.04.006. Epub 2016 Jul 15.

Authors

Nima Hafezi-Nejad¹, John A Carrino², John Eng³, Craig Blackmore⁴, Jaimie Shores⁵, Scott D Lifchez⁵, Sahar Jalali Farahani³, Shadpour Demehri³

Affiliations

¹ Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287. Electronic address: nhafezi1@jhmi.edu.
² Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York.
³ Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287.
⁴ The Center for Healthcare Improvement Science and Department of Radiology, Virginia Mason Medical Center, Seattle, Washington.
⁵ Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland.

PMID: 27426979
DOI: 10.1016/j.acra.2016.04.006

Abstract

Rationale and objectives: The study aimed to perform a systematic review and meta-analysis for evaluating the diagnostic accuracy of 1.5 Tesla and 3.0 Tesla magnetic resonance imaging (MRI), and magnetic resonance arthrography (MRA), in the detection of scapholunate interosseous ligament (SLIL) injury.

Materials and methods: A literature search was performed (until July 2015) using the PubMed (MEDLINE), Embase, ISI Web of Science, Scopus, and conference proceedings. Original studies evaluating the diagnostic accuracy of MRI or MRA in the detection of SLIL injuries using arthroscopy or open surgery as the reference standard were included.

Results: Of the initial 930 published records and 103 conference proceedings, 24 studies (1902 MRI examinations) were included (median SLIL injury prevalence: 33% [interquartile range: 25-42]). Heterogeneity was detected for 1.5 T MRI (chi-square: 47.93, P < 0.001) but not for 3.0 T MRI (chi-square: 8.00, P value: 0.09) and MRA (chi-square: 14.54, P value: 0.34) studies. The sensitivities of 1.5 T MRI, 3.0 T MRI, and MRA for detection of SLIL injury were 45.7% (95% confidence interval: 40.1-51.4), 75.7% (66.8-83.2), and 82.1% (76.1-87.2), respectively. The specificities of 1.5 T MRI, 3.0 T MRI, and MRA for detection of SLIL injury were 80.5% (77.3-83.4), 97.1% (89.8-99.6), and 92.8% (90.2-94.9), respectively. The diagnostic odds ratios of 1.5 T MRI, 3.0 T MRI, and MRA for detection of SLIL injury were 5.56 (2.71-11.39), 23.23 (3.16-171.00), and 65.04 (32.89-128.62) (P value < 0.001), respectively. The results were consistent after addressing publication bias and sensitivity analyses.

Conclusions: MRA is superior to 3.0 T MRI, and 3.0 T MRI is superior to 1.5 T MRI in terms of diagnostic performance. 3.0 T MRI has the highest specificity for the detection of SLIL injuries.

Keywords: MRI; diagnostic accuracy; interosseous ligament; scapholunate; sensitivity; specificity; wrist.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Adult
Arthrography / methods*
Female
Humans
Ligaments / diagnostic imaging*
Ligaments / injuries*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Wrist Injuries / diagnostic imaging*