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Diagnostic performance of MRA in abduction and external rotation position in the detection of glenoid labral lesions: a systematic review and meta-analysis

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Abstract

Objective

To compare the diagnostic performance of direct magnetic resonance arthrography (MRA) for labral lesions during conventional, abduction and external rotation (ABER), conventional plus abduction, and external rotation (ABER) positioning by using a systematic review and meta-analysis.

Materials and methods

A comprehensive literature search was performed on the two main concepts of magnetic resonance arthrography: extremity position and labral lesions. Inclusion criteria consisted of original studies that assessed the diagnostic accuracy of MR arthrography in ABER and conventional position alone or combined for the diagnosis of labral lesions by using surgical findings as the reference standard. Meta-analyses were performed that compared MR arthrography during conventional positioning, ABER, and conventional plus ABER positioning.

Results

Nine studies met the inclusion and exclusion criteria. A total of 733, 504, and 313 lesions assessed by conventional MRA, ABER MRA, and conventional plus ABER MRA, respectively, were included in our analysis. Pooled sensitivities of MRA in conventional, ABER, and conventional plus ABER position for labral tear diagnosis were 81.5%, 81.6%, and 95.7%, respectively. Pooled specificities of MRA in conventional, ABER, and conventional plus ABER position for labral tear diagnosis were 88.8%, 85.6%, and 94.5%, respectively. Summary receiver operator characteristic (ROC) curve demonstrated improved accuracy of conventional plus ABER MRA compared with conventional MRA or ABER MRA with the area under the curve (AUC) of 0.99, 0.90, and 0.88, respectively.

Conclusion

Conventional plus ABER MRA showed increased diagnostic accuracy compared to both ABER MRA and conventional MRA alone in the diagnosis of labral lesions.

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Acknowledgements

The authors thank Amirhossein Ramezani Ahmadi, PhD, for assistance in the statistical analysis.‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬

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Authors and Affiliations

  1. Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, 4245 Roosevelt Way NE, Box 354755, Seattle, WA, USA

    Mehrzad Shafiei, Firoozeh Shomal Zadeh & Majid Chalian

  2. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Akbar Shafiee

  3. Musculoskeletal Imaging and Intervention, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA

    Maryam Soltanolkotabi

  4. Department of Orthopedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA

    Albert O. Gee

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  1. Mehrzad Shafiei
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Correspondence to Majid Chalian.

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Shafiei, M., Shomal Zadeh, F., Shafiee, A. et al. Diagnostic performance of MRA in abduction and external rotation position in the detection of glenoid labral lesions: a systematic review and meta-analysis. Skeletal Radiol 51, 1611–1621 (2022). https://doi.org/10.1007/s00256-022-03996-9

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  • DOI: https://doi.org/10.1007/s00256-022-03996-9

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