The diagnostic accuracy of ultrasound in assessing anterior cruciate ligament tears: a systematic review and meta-analysis.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Skeletal Radiology Pub Date : 2025-01-14 DOI:10.1007/s00256-025-04866-w

Gabriella Schreiner, Stephen Fucaloro, Mark Ward, Laura Krivicich, Jack Bragg, Matthew Harkey, Matthew Salzler

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引用次数: 0

Abstract

Background: Advances in technology and affordability of ultrasound (US) have expanded its use in the evaluation of musculoskeletal injuries. However, US accuracy for diagnosing anterior cruciate ligament (ACL) injuries remains inconsistently reported in the literature.

Hypothesis/purpose: Systematically review the literature and perform a meta-analysis to statistically evaluate the accuracy of US in diagnosing ACL tears.

Methods: PubMed, Embase, and Web of Science databases were queried for studies comparing US to MRI or arthroscopy for diagnosing ACL tears. Studies evaluating US techniques including anterior tibial translation relative to the femur, hematoma at the ACL insertion ("notch sign"), or direct ACL visualization were pooled using random-effects models to generate sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV). A p-value less than 0.05 was used to indicate statistical significance.

Results: Across 12 studies, US correctly identified 419/518 (81%) of confirmed ACL injuries and 425/465 (91%) of uninjured ACLs. Meta-analysis showed high overall specificity (92%, I² = 24%), but variable sensitivity (84%, I² = 86%). PPVs were high for notch sign (96%, I² = 0%) and anterior translation (97%, I² = 0%) but low for visualization (77%, I² = 70%). NPVs were heterogeneous across techniques (notch sign 73%, I² = 90%; visualization 87%, I² = 0%; anterior translation 83%, I² = 88%).

Conclusion: Ultrasound demonstrates high specificity (92%) and PPV (92%) for diagnosis of ACL tears compared to confirmed tears but is limited by fair sensitivity (84%) and NPV (83%).

查看原文本刊更多论文

超声诊断前交叉韧带撕裂的准确性：一项系统回顾和荟萃分析。

背景：技术的进步和超声（US）的可负担性扩大了其在肌肉骨骼损伤评估中的应用。然而，美国诊断前交叉韧带（ACL）损伤的准确性在文献报道中仍然不一致。假设/目的：系统回顾文献并进行meta分析，统计评估US诊断前交叉韧带撕裂的准确性。方法：查询PubMed、Embase和Web of Science数据库，比较US与MRI或关节镜诊断前交叉韧带撕裂的研究。评估US技术的研究包括相对于股骨的胫骨前平移、ACL插入处血肿（“缺口符号”）或直接ACL可视化，使用随机效应模型进行合并，以产生敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。p值小于0.05表示差异有统计学意义。结果：在12项研究中，US正确识别了419/518例（81%）确诊的ACL损伤和425/465例（91%）未受伤的ACL。meta分析显示高的总特异性（92%,I2 = 24%），但可变敏感性（84%,I2 = 86%）。缺口征（96%,I2 = 0%）和前平移（97%,I2 = 0%）的ppv高，而可视化（77%,I2 = 70%）的ppv低。不同技术的npv是异质的(缺口符号73%，I2 = 90%；可视化87%，I2 = 0%；前平移83%，I2 = 88%)。结论：超声诊断前交叉韧带撕裂具有较高的特异性（92%）和PPV(92%)，但受限于公平的敏感性（84%）和NPV（83%）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Skeletal Radiology 医学-核医学

CiteScore

4.40

自引率

9.50%

发文量

253

审稿时长

3-8 weeks

期刊介绍： Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.