Meta分析

已发表的文献从1966 年到2007年9月，包 括所有语言和人类及 动物课题。
• Study Selection • Our query of the MEDLINE database returned 1,195 hits. The articles were analyzed for concordance with the inclusion criteria. These criteria are English language; absolute (raw) data on rotator cuff tears (full or partial thickness or both) in the form of true-positives(TPs), truenegatives(TNs), false-positives (FPs), and falsenegatives(FNs) either provided or extractable;surgical reference standard (arthroscopy or open surgery); and diagnostic imaging studies interpreted by radiologists.
• In addition, data must not have been published in a prior study. To prevent this possibility, we included only the article with the earlier publication date if two articles with common authors or from the same institution had overlapping dates of subject inclusion.
• RESULTS. • Sixty-five articles met the inclusion criteria for this metaanalysis. In diagnosing a fullthickness tear or a partialthickness rotator cuff tear, MR arthrography is more sensitive and specific than either MRI or ultrasound (p < 0.05). There are no significant differences in either sensitivity or specificity between MRI and ultrasound in the diagnosis of partial- or full-thickness rotator cuff tears (p > 0.05).
目的：通过学习 文献进行一个 meta分析，来比 较MRI、MR关节 造影和超声在诊 断肩袖撕裂的准 确性。
• MATERIALS AND METHODS. • Articles reporting the sensitivities and specificities of MRI, MR arthrography, or ultrasound for the diagnosis of rotator cuff tears were identified. Surgical(open and arthroscopic) reference standard was an inclusion criterion. Summary statistics were generated using pooled data. Scatterplots of the data sets were plotted on a graph of sensitivity versus (1 – specificity). Receiver operating characteristic (ROC) curves were generated.
MR关节造影、MRI、超 声在概括ROC曲线上， 对所有撕裂，MR关节 造影的ROC曲线最棒 （0.935），超声次之 （0.889），MRI（0， 878），但是，成对比 较这些曲线，MRI和超 声没有显著区别 （p>0.05）。
• CONCLUSION. • MR arthrography is the most sensitive and specific technique for diagnosing both full- and partialthickness rotator cuff tears. Ultrasound and MRI are comparable in both sensitivity and specificity.
另外，在先前的研究 中，数据不能已发表。 为了避免这种可能性， 如果两篇文章有相同 作者或结论有重叠且 来自同一研究机构， 我们仅选录发表时间 较早的文章。
• Non-English-language (n = 160) and animal (n =1) studies were excluded. The abstracts of the remaining studies were evaluated for relevance to our study. • Of these, 270 relevant articles were retrieved. One hundred sixty-two of the 270 were excluded because either raw data were not provided or the data could not be extracted into discrete TPs, TNs, FPs, and FNs.
多种成像检测已经经 常用于衡量疼痛的肩 关节：非增强MRI、 间接或直接MR关节 造影、超声，在诊断 肩袖撕裂时已成为标 准。
• Materials and Methods • A comprehensive literature search of the MEDLINE database was performed using the following keywords: rotator cuff and rotator cuff tear; magnetic resonance imaging, magnetic resonance, MRI, and MR; magnetic resonance arthrography and MR arthrography; ultrasound,ultrasonography, sonography, and US.
结果：65篇文章符合这 个meta分析的收入标准。 在诊断一个完全或部分 的肩袖撕裂时，MR关 节造影比MRI或超声更 敏感和专业（p<0.05）。 在诊断完全或部分肩袖 撕裂时，MRI和超声在 敏感性和特异性方面没 有显著区别（p>0.05）。
• Summary ROC curves for MR arthrography,MRI, and ultrasound for all tears show the area under the ROC curve is greatest for MR arthrography (0.935), followed by ultrasound (0.889) and then MRI (0.878); however,pairwise comparisons of these curves show no significant differences between MRI and ultrasound(p > 0.05).
材料和方法 在操作一个广泛的 MEDLINE数据库信息 资源和文献搜索时我 们用了以下几个关键 词：肩袖和肩袖撕裂， 核磁共振成像，核磁 共振，MRI和MR，核 磁关节造影和MR关 节造影，超声，超声 成像，超声学和US。
• Articles published from 1966 to September 2007 were searched and included publications in all languages and involving human and animal subjects.
Accuracy of MRI, MR Arthrography, and Ultrasound in the Diagnosis of Rotator Cuff Tears: A Meta-Analysis
MRI、MR关节造影、超声诊断肩袖 撕裂的准确性：Meta分析
• OBJECTIVE. • The purpose of this study was to compare the diagnostic accuracy of MRI,MR arthrography, and ultrasound for the diagnosis of rotator cuff tears through a metaanalysis of the studies in the lit imaging tests that have been used to evaluate the painful shoulder, unenhanced MRI, indirect and direct MR arthrography, and ultrasound have become the standards by which a rotator cuff tear is diagnosed.
材料与方法：文献报道， MRI、MR关节造影和超 声在诊断肩袖撕裂的敏 感性和特异性是确定的。 外科手术（切开和关节 镜）的证明标准是一种 收入标准，通过对汇总 数据的总结形成统计数 字、数据设置的散点绘 图，在一张敏感性对 （1-特异性）的图上进 行标绘，就形成 Receiver operating characteristic（ROC）曲 线。