An Evidence-Based Approach to Assess the Accuracy of MRI in Diagnosing Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Abstract

Background: A precise preoperative diagnosis is important for the treatment of patients, and the extent of rotator cuff tears will determine the patient’s choice of conservative treatment or surgical treatment. Objectives: This paper was conducted to assess the diagnostic accuracy of magnetic resonance imaging (MRI) in the evaluation of rotator cuff tears. Materials and Methods: A computerized search using PubMed, EMBASE, Chinese Biomedical databases, Web of Knowledge, and Cochrane Libraries was performed to identify original research studies by two independent reviewers separately. Results: Eighteen surveys that investigated MRI to diagnose rotator cuff tears were included. Influence factors on the diagnostic accuracy were evaluated using meta-regression analysis. For any rotator cuff tear, the pooled sensitivity and specificity were 0.93 and 0.88, respectively. Overall, MRI had higher pooled sensitivity (0.87) and specificity (0.93) of full-thickness tears, relative to sensitivity (0.80) and specificity (0.92) of partial tears. In addition, the overall area under the curve (AUC) of MRI for identifying full-thickness tears (96%) was close to that for any rotator cuff tear, a value that was much higher than for partial tears (86%). Threshold effects were not significant in this meta-analysis. Conclusion: After analyzing the results of this study, we demonstrated that MRI had excellent performance regarding the diagnosis of rotator cuff tears. Our study showed that the diagnostic accuracy of MRI in diagnosing full-thickness rotator cuff tear is significantly better than that of partial thickness rotator cuff tears.