标题：Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies
作者：Liu, Fanxiao; Dong, Jinlei; Shen, Wun-Jer; Kang, Qinglin; Zhou, Dongsheng; Xiong, Fei
作者机构：[Shen, Wun-Jer; Kang, Qinglin; Xiong, Fei] Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China.; [Kang, Qinglin; Xiong, Fei] Shanghai Jiao Ton 更多
通讯作者地址：[Liu, FX]Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 6, Dept Orthoped Surg, Yishan Rd 600, Shanghai 200233, Peoples R China.
来源：ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE
关键词：rotator cuff tear; MRA; MRI; ultrasound; shoulder pain
摘要：Background:; Many imaging techniques have been developed for the detection of rotator cuff tears (RCTs). Despite numerous quantitative diagnostic studies, their relative accuracy remains inconclusive.; Purpose:; To determine which of 3 commonly used imaging modalities is optimal for the diagnosis of RCTs.; Study Design:; Systematic review; Level of evidence, 4.; Methods:; Studies evaluating the performance of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and ultrasound (US) used in the detection of RCTs were retrieved from the PubMed/MEDLINE and Embase databases. Diagnostic data were extracted from articles that met the inclusion/exclusion criteria. A network meta-analysis was performed using an arm-based model to pool the absolute sensitivity and specificity, relative sensitivity and specificity, and diagnostic odds ratio as well as the superiority index for ranking the probability of these techniques.; Results:; A total of 144 studies involving 14,059 patients (14,212 shoulders) were included in this network meta-analysis. For the detection of full-thickness (FT) tears, partial-thickness (PT) tears, or any tear, MRA had the highest sensitivity, specificity, and superiority index. For the detection of any tear, MRI had better performance than US (sensitivity: 0.84 vs 0.81, specificity: 0.86 vs 0.82, and superiority index: 0.98 vs 0.22, respectively). With regard to FT tears, MRI had a higher sensitivity and superiority index than US (0.91 vs 0.87 and 0.67 vs 0.28, respectively) and a similar specificity (0.88 vs 0.88, respectively). The results for PT tears were similar to the detection of FT tears. A sensitivity analysis was performed by removing studies involving only 1 arm for FT tears, PT tears, or any tear, and the results remained stable.; Conclusion:; This network meta-analysis of diagnostic tests revealed that high-field MRA had the highest diagnostic value for detecting any tear, followed by low-field MRA, high-field MRI, high-frequency US, low-field MRI, and low-frequency US. These findings can help guide clinicians in deciding on the appropriate imaging modality.