To compare the diagnostic efficacy of CT and MRI in the evaluation of occult hip fracture: A Meta-Analysis

doi:10.3877/cma.j.issn.2096-0263.2022.04.010

Abstract

Abstract:

Objective

To summarize the data of occult hip fracture and analyze better diagnostic methods by comparing CT and MRI imaging techniques.

Methods

The literature on CT and MRI evaluation of occult hip fractures published in the English literature database from the establishment of the database to 2022 was statistically analyzed by meta-analysis. The heterogeneity of the included studies was analyzed by Review Manager 5.3 software, and the publication bias was tested by Stata 12.0 software.

Results

10 articles were finally included in this study. Although the AUC area of MRI was greater than that of CT, there was no significant difference (z=1.33<1.96, P>0.05); The specificity of MRI in the diagnosis of occult hip fracture was significantly higher than that of CT(P<0.05).

Conclusions

for patients with negative X-ray examination after hip trauma, but still suspected to have obvious fracture or pain symptoms, MRI is recommended as a necessary item, which can significantly improve the detection rate and diagnostic accuracy of occult fracture, and provide accurate and reliable basis for clinical diagnosis and reasonable selection of treatment scheme.

Key words: Occult fracture of hip, Meta analysis, CT imaging, MRI imaging

Zuzhuo Zhang, Yali Wang, Dongdong Han, Na Liu, Wenjuan Wu, Haitian Liu. To compare the diagnostic efficacy of CT and MRI in the evaluation of occult hip fracture: A Meta-Analysis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(04): 250-256.

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URL: https://zhlngkykfdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-0263.2022.04.010

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Figures/Tables 8

References 23

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研究文献	年份	结果	病例数	年龄	参考标准	试验设计类型	研究目的
Cabarrus^[9]	2008	CT vs. MRI	145	65.9±17.7	影像随访和临床病史	回顾性研究	比较CT和MRI对隐匿性骨折的灵敏度
Gill^[10]	2013	CT vs. MRI	92	82（52-100）	手术和随访	回顾性研究	比较CT和MRI对隐匿性骨折的敏感性
Haubro^[11]	2015	CT vs. MRI	67	80.5	随访	前瞻性队列研究	评估股骨近端骨折CT和MRI的灵敏度和特异度
Collin^[12]	2016	CT vs. MRI	44	79（60-96）	影像学和临床随访	回顾性研究	评估CT和MRI对髋部隐匿性骨折的诊断效果
Sadozai^[13]	2016	CT	78	None	临床随访	回顾性研究	CT诊断股骨颈隐匿性骨折的灵敏度
Mandell^[14]	2018	CT	74	73（27-102）	临床随访	回顾性研究	CT对髋部隐匿性骨折的诊断价值
Lanotte^[15]	2020	CT vs. MRI	102	83±8.8 76.8±10.1	临床随访	双中心前瞻性研究	CT以及MRI对股骨隐匿性骨折诊断价值
Kutaiba^[16]	2020	CT	181	82（71-89）	影像随访和临床病史	回顾性研究	CT以及进一步MRI对股骨颈隐匿性骨折诊断
Rehman^[17]	2016	CT vs.MRI	71	82±13	影像随访和临床病史	回顾性研究	CT以及MRI评估隐匿性骨折
Davidson^[18]	2021	CT vs.MRI	103	78.4（22-103）	影像随访和临床病史	回顾性研究	CT以及CT+MRI的评估髋部隐匿性骨折

研究文献	年份	结果	病例数	年龄	参考标准	试验设计类型	研究目的
Cabarrus^[9]	2008	CT vs. MRI	145	65.9±17.7	影像随访和临床病史	回顾性研究	比较CT和MRI对隐匿性骨折的灵敏度
Gill^[10]	2013	CT vs. MRI	92	82（52-100）	手术和随访	回顾性研究	比较CT和MRI对隐匿性骨折的敏感性
Haubro^[11]	2015	CT vs. MRI	67	80.5	随访	前瞻性队列研究	评估股骨近端骨折CT和MRI的灵敏度和特异度
Collin^[12]	2016	CT vs. MRI	44	79（60-96）	影像学和临床随访	回顾性研究	评估CT和MRI对髋部隐匿性骨折的诊断效果
Sadozai^[13]	2016	CT	78	None	临床随访	回顾性研究	CT诊断股骨颈隐匿性骨折的灵敏度
Mandell^[14]	2018	CT	74	73（27-102）	临床随访	回顾性研究	CT对髋部隐匿性骨折的诊断价值
Lanotte^[15]	2020	CT vs. MRI	102	83±8.8 76.8±10.1	临床随访	双中心前瞻性研究	CT以及MRI对股骨隐匿性骨折诊断价值
Kutaiba^[16]	2020	CT	181	82（71-89）	影像随访和临床病史	回顾性研究	CT以及进一步MRI对股骨颈隐匿性骨折诊断
Rehman^[17]	2016	CT vs.MRI	71	82±13	影像随访和临床病史	回顾性研究	CT以及MRI评估隐匿性骨折
Davidson^[18]	2021	CT vs.MRI	103	78.4（22-103）	影像随访和临床病史	回顾性研究	CT以及CT+MRI的评估髋部隐匿性骨折

研究文献	TP	FP	FN	TN	Se	Sp
Cabarrus	34	30	0	81	0.53	1.00
Gill	19	4	0	38	0.86	1.00
Haubro	9	8	2	48	0.67	0.96
Collin	11	9	7	17	0.55	0.71
Sadozai	24	4	1	49	0.86	0.98
Lanotte	27	2	0	160	0.93	1.00
Kutaiba	22	5	2	155	0.81	0.98
Mandell	22	3	1	48	0.88	0.98

研究文献	TP	FP	FN	TN	Se	Sp
Cabarrus	34	30	0	81	0.53	1.00
Gill	19	4	0	38	0.86	1.00
Haubro	9	8	2	48	0.67	0.96
Collin	11	9	7	17	0.55	0.71
Sadozai	24	4	1	49	0.86	0.98
Lanotte	27	2	0	160	0.93	1.00
Kutaiba	22	5	2	155	0.81	0.98
Mandell	22	3	1	48	0.88	0.98

研究文献	TP	FP	FN	TN	Se	Sp
Cabarrus	63	1	0	81	0.98	1.00
Haubro	15	2	6	44	0.87	0.88
Collin	20	0	0	24	1.00	1.00
Lanotte	28	1	2	158	0.97	0.99

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