The Diagnostic Value of MR Imaging for Anterior Cruciate Ligament Tears: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

JING Tianzhong ^1,2 , TIAN Jinhui ¹ ,  YANG Kehu ¹

1. Evidence-Based Medicine Center of Lanzhou University, the First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;2. The First People’s Hospital of Wudu District, Longnan 746000, China;

Corresponding author：

YANG Kehu, Email: yangkh2006@163.com

Keywords：

Anterior cruciate ligament; MR imaging; Systematic review

DOI：

10.7507/1672-2531.20090099

Video：

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Objective 　To evaluate the diagnostic value of MR imaging for anterior cruciate ligament.
Methods 　We searched PubMed, EMBASE, CBM, CSJD and CJFD to find all diagnostic tests about MR imaging in anterior cruciate ligament. QUADAS items were used to evaluate the quality of the included studies. We used Meta-disc software for data collection, and sensitivity, specificity and SROC curves were calculated to assess the diagnostic value of individual diagnostic tests.
Results 　Twenty-nine studies met the eligibility criteria and were included. Compared with arthroscope, the summary values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and SROC curve of MR imaging were 93%, 93%, 9.85, 126.39, and 0.971 4, respectively.
Conclusion 　MR imaging can be regarded as an effective and feasible method for ACL tears diagnosis and screening clinically, based on the results of this systematic review.

Citation： JING Tianzhong,TIAN Jinhui,YANG Kehu. The Diagnostic Value of MR Imaging for Anterior Cruciate Ligament Tears: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(5): 536-541. doi: 10.7507/1672-2531.20090099 Copy

1.	胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 北京: 人民军医出版社, 2001. 714.
2.	Frank CB, Jackson DW. The sciences of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am, 1997, 79(10): 1556-1576.
3.	Arendt E, Dick R. Knee injury patterns among men and wemen in collegiate basketball and soccer: NCAA Data and review of literature.Am J Sports Med, 1995, 23(6): 694.
4.	De Marea M, Barbiera F, Lo Casto, et al. Biomechical correlations of lesions. Associated with traumatic disease of the anterior cruciate ligament:Analysis with magnetic resonance. Radiol Med Torino, 1996, 91(6): 693.
5.	Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athletic Training, 1999, 34(2): 86-92.
6.	Reicher MA, Hartzman S, Bassett LW, et al. MR Imaging of the knee joint Part: Tranmatic disorders. Radiology, 1987, 162(2): 547. 19.
7.	Schweitzer ME, Tran D, Deely DM, et al. Medial collateral ligament in juries: evaluation of multiple sign, prevalence and location of associated bone bruises, and assessment with MR imaging.Radiology, 1995,194(4): 825-829.
8.	Liehtinghagen R, Bahr M. Noninvasive diagnosis of fibrosis in chronic liver disease. Expert Re Mo1 Diagn, 2004, 4(51): 715-726.
9.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
10.	许建荣, 邓霞, 华佳, 等. 前交叉韧带不全撕裂的MRI诊断. 中国医学计算机成像杂志, 2000, (6): 401-403.
11.	刘俭, 徐颖, 杜领娣, 等. 超声、MRI及临床稳定性试验评价膝关节前交叉韧带损伤比较. 中国医学影像技术, 2001, 17(4): 337-338.
12.	周根泉, 张悦萍, 张贵祥, 等. 膝关节前交叉韧带撕裂的MRI诊断. 中国医学影像技术, 2002, (11): 1146-1150.
13.	孙水, 张伟, 王健. 前交叉韧带损伤的MRI诊断与关节镜下所见的比较研究. 医学影像学杂志, 2003, 13(10): 764-766.
14.	高凯, 王立德, 齐志明, 等. 前交叉韧带损伤的MRI诊断与临床诊断比较研究. 中国运动医学杂志, 2005, 24(5): 521-525.
15.	谢峰, 杨柳, 郭林, 等. 前交叉韧带损伤MRI诊断价值与治疗方案选择的初步研究. 重庆医学, 2006, 35(20): 1850-1852.
16.	孔德伟, 贾文霄, 张克远, 等. 膝关节前交叉韧带撕裂的MRI诊断及分析. 新疆医科大学学报, 2006, 29(6): 536-538.
17.	Lee JK, Yao L, Phelps CT, et al. Anterior Cruciate Ligament Tears: MR Imaging Compared with Arthroscopy and Clinical Tests. Radiology, 1988, 166: 861-864.
18.	Boeree NR, Watkinson AF, Ackroyd CE, et al. Magnetic resonance imaging of meniscal and cruciate injuries of the knee. J Bone Joint Surg Br, 1991, 73: 452-457.
19.	Fischer SP, Fox JM, Del Pizzo W, et al. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am, 1991, 73: 2-10.
20.	Kelly MA, Flock TJ, Kimmel JA, et al. MR imaging of the knee: clarification of its role. Arthroscopy, 1991, 7: 78-85.
21.	Niitsu M, Anno I, Fukubayashi T, et al. Tears of cruciate ligaments and menisci:evaluation with cine MR imaging. Radiology, 1991, 178: 859-864.
22.	Gluckert K, Kladny B, Blank-Schal A, et al. MRI of the knee joint with a 3-Dgradient echo sequence: equivalent to diagnostic arthroscopy? Arch Orthop TraumaSurg, 1992, 112: 5-14.
23.	Grevitt MP, Pool CJ, Bodley RN, et al. Magnetic resonance imaging of the knee: initial experience in a district general hospital.Injury,1992, 23: 410-412.
24.	Heron CW, Calvert PT. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology, 1992, 183: 839-844.
25.	Barnett MJ. MR diagnosis of internal derangements of the knee:effect of field strength on efficacy. AJR Am J Roentgenol, 1993, 161: 115-118.
26.	Chan WP, Peterfy C, Fritz RC, et al. MR diagnosis of complete tears of the anterior cruciate ligament of the knee:importance of anterior subluxation of the tibia. AJR Am J Roentgenol, 1994, 62: 355-360.
27.	Gentili A, Seeger LL, Yao L, et al. Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology, 1994, 193: 835-840.
28.	Kinnunen J, Bondestam S, Kivioja A, et al. Diagnostic performance of low field MRI in acute knee injuries. Magn Reson Imaging, 1994, 12: 1155-1160.
29.	Chen MC, Shih TT, Jiang CC, et al. MRI of meniscus and cruciate ligament tears correlated with arthroscopy. J Formos Med Assoc, 1995, 94: 605-611.
30.	Lerman JE, Gray DS, Schweitzer ME, et al. MR evaluation of the anterior cruciate ligament: value of axial images. J Comput Assist Tomogr, 1995, 19: 604-607.
31.	Barry KP, Mesgarzadeh M, Triolo J, et al. Accuracy of MRI patterns in evaluating anterior cruciate ligament tears. Skeletal Radiol, 1996, 25: 365-370.
32.	Bui-Mansfield LT, Youngberg RA, Warme W, et al. Potential cost savings of MR imaging obtained before arthroscopy of the knee:evaluation of 50 consecutive patients. Am J Roentgenol, 1997, 168: 913-918.
33.	Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries:a double-blind comparison of 47 patients. Acta Orthop Scand, 1997, 68: 277-281.
34.	Ha TP, Li KC, Beaulieu CF, et al. Anterior cruciate ligament injury:fast spin-echo MR imaging with arthroscopic correlation in 217 examinations. Am J Roentgenol, 1998, 170: 1215-1219.
35.	Cotten A, Delfaut E, Demondion X, et al. MR imaging of the knee at 0.2 and 1.5 T:correlation with surgery. Am J Roentgenol, 2000, 174: 1093-1097.
36.	Chung HW, Kim YH, Hong SH, et al. Indirect signs of anterior cruciate ligament injury on SPET: Comparison with MRI an d arthroscopy. Nuclear Medicine Communications, 2000, 21: 651-658.
37.	Kocabey Y, Tetik O, Isbell WM, et al. The Value of Clinical Examination Versus Magnetic Resonance Imaging in the Diagnosis of Meniscal Tears and Anterior Cruciate Ligament Rupture. The Journal of Arthroscopic and Related, Surgery, 2004, 20(7): 696-700.
38.	Duc SR, Zanetti M, Kramer J, et al. Magnetic resonance imaging of ACL tears: evaluation of standard orthogonal and tailored paraconal images. Acta radiological, 2005, (7): 729-734.
39.	Patrick M, Bossuyt JB, Reitsma DE, et al. The STARD statement for reporting studies of diagnosis accuracy:explanation and elaboration.Croat Med J, 2003, 44: 639-650.

1. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 北京: 人民军医出版社, 2001. 714.
2. Frank CB, Jackson DW. The sciences of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am, 1997, 79(10): 1556-1576.
3. Arendt E, Dick R. Knee injury patterns among men and wemen in collegiate basketball and soccer: NCAA Data and review of literature.Am J Sports Med, 1995, 23(6): 694.
4. De Marea M, Barbiera F, Lo Casto, et al. Biomechical correlations of lesions. Associated with traumatic disease of the anterior cruciate ligament:Analysis with magnetic resonance. Radiol Med Torino, 1996, 91(6): 693.
5. Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athletic Training, 1999, 34(2): 86-92.
6. Reicher MA, Hartzman S, Bassett LW, et al. MR Imaging of the knee joint Part: Tranmatic disorders. Radiology, 1987, 162(2): 547. 19.
7. Schweitzer ME, Tran D, Deely DM, et al. Medial collateral ligament in juries: evaluation of multiple sign, prevalence and location of associated bone bruises, and assessment with MR imaging.Radiology, 1995,194(4): 825-829.
8. Liehtinghagen R, Bahr M. Noninvasive diagnosis of fibrosis in chronic liver disease. Expert Re Mo1 Diagn, 2004, 4(51): 715-726.
9. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
10. 许建荣, 邓霞, 华佳, 等. 前交叉韧带不全撕裂的MRI诊断. 中国医学计算机成像杂志, 2000, (6): 401-403.
11. 刘俭, 徐颖, 杜领娣, 等. 超声、MRI及临床稳定性试验评价膝关节前交叉韧带损伤比较. 中国医学影像技术, 2001, 17(4): 337-338.
12. 周根泉, 张悦萍, 张贵祥, 等. 膝关节前交叉韧带撕裂的MRI诊断. 中国医学影像技术, 2002, (11): 1146-1150.
13. 孙水, 张伟, 王健. 前交叉韧带损伤的MRI诊断与关节镜下所见的比较研究. 医学影像学杂志, 2003, 13(10): 764-766.
14. 高凯, 王立德, 齐志明, 等. 前交叉韧带损伤的MRI诊断与临床诊断比较研究. 中国运动医学杂志, 2005, 24(5): 521-525.
15. 谢峰, 杨柳, 郭林, 等. 前交叉韧带损伤MRI诊断价值与治疗方案选择的初步研究. 重庆医学, 2006, 35(20): 1850-1852.
16. 孔德伟, 贾文霄, 张克远, 等. 膝关节前交叉韧带撕裂的MRI诊断及分析. 新疆医科大学学报, 2006, 29(6): 536-538.
17. Lee JK, Yao L, Phelps CT, et al. Anterior Cruciate Ligament Tears: MR Imaging Compared with Arthroscopy and Clinical Tests. Radiology, 1988, 166: 861-864.
18. Boeree NR, Watkinson AF, Ackroyd CE, et al. Magnetic resonance imaging of meniscal and cruciate injuries of the knee. J Bone Joint Surg Br, 1991, 73: 452-457.
19. Fischer SP, Fox JM, Del Pizzo W, et al. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am, 1991, 73: 2-10.
20. Kelly MA, Flock TJ, Kimmel JA, et al. MR imaging of the knee: clarification of its role. Arthroscopy, 1991, 7: 78-85.
21. Niitsu M, Anno I, Fukubayashi T, et al. Tears of cruciate ligaments and menisci:evaluation with cine MR imaging. Radiology, 1991, 178: 859-864.
22. Gluckert K, Kladny B, Blank-Schal A, et al. MRI of the knee joint with a 3-Dgradient echo sequence: equivalent to diagnostic arthroscopy? Arch Orthop TraumaSurg, 1992, 112: 5-14.
23. Grevitt MP, Pool CJ, Bodley RN, et al. Magnetic resonance imaging of the knee: initial experience in a district general hospital.Injury,1992, 23: 410-412.
24. Heron CW, Calvert PT. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology, 1992, 183: 839-844.
25. Barnett MJ. MR diagnosis of internal derangements of the knee:effect of field strength on efficacy. AJR Am J Roentgenol, 1993, 161: 115-118.
26. Chan WP, Peterfy C, Fritz RC, et al. MR diagnosis of complete tears of the anterior cruciate ligament of the knee:importance of anterior subluxation of the tibia. AJR Am J Roentgenol, 1994, 62: 355-360.
27. Gentili A, Seeger LL, Yao L, et al. Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology, 1994, 193: 835-840.
28. Kinnunen J, Bondestam S, Kivioja A, et al. Diagnostic performance of low field MRI in acute knee injuries. Magn Reson Imaging, 1994, 12: 1155-1160.
29. Chen MC, Shih TT, Jiang CC, et al. MRI of meniscus and cruciate ligament tears correlated with arthroscopy. J Formos Med Assoc, 1995, 94: 605-611.
30. Lerman JE, Gray DS, Schweitzer ME, et al. MR evaluation of the anterior cruciate ligament: value of axial images. J Comput Assist Tomogr, 1995, 19: 604-607.
31. Barry KP, Mesgarzadeh M, Triolo J, et al. Accuracy of MRI patterns in evaluating anterior cruciate ligament tears. Skeletal Radiol, 1996, 25: 365-370.
32. Bui-Mansfield LT, Youngberg RA, Warme W, et al. Potential cost savings of MR imaging obtained before arthroscopy of the knee:evaluation of 50 consecutive patients. Am J Roentgenol, 1997, 168: 913-918.
33. Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries:a double-blind comparison of 47 patients. Acta Orthop Scand, 1997, 68: 277-281.
34. Ha TP, Li KC, Beaulieu CF, et al. Anterior cruciate ligament injury:fast spin-echo MR imaging with arthroscopic correlation in 217 examinations. Am J Roentgenol, 1998, 170: 1215-1219.
35. Cotten A, Delfaut E, Demondion X, et al. MR imaging of the knee at 0.2 and 1.5 T:correlation with surgery. Am J Roentgenol, 2000, 174: 1093-1097.
36. Chung HW, Kim YH, Hong SH, et al. Indirect signs of anterior cruciate ligament injury on SPET: Comparison with MRI an d arthroscopy. Nuclear Medicine Communications, 2000, 21: 651-658.
37. Kocabey Y, Tetik O, Isbell WM, et al. The Value of Clinical Examination Versus Magnetic Resonance Imaging in the Diagnosis of Meniscal Tears and Anterior Cruciate Ligament Rupture. The Journal of Arthroscopic and Related, Surgery, 2004, 20(7): 696-700.
38. Duc SR, Zanetti M, Kramer J, et al. Magnetic resonance imaging of ACL tears: evaluation of standard orthogonal and tailored paraconal images. Acta radiological, 2005, (7): 729-734.
39. Patrick M, Bossuyt JB, Reitsma DE, et al. The STARD statement for reporting studies of diagnosis accuracy:explanation and elaboration.Croat Med J, 2003, 44: 639-650.

Chinese Journal of Evidence-Based Medicine

The Diagnostic Value of MR Imaging for Anterior Cruciate Ligament Tears: A Systematic Review

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