PDF(Pubmed)
Abstract：
BACKGROUND: Knee injuries are prevalent, and early diagnosis is crucial for guiding clinical therapy. MRI is the diagnostic gold standard for bone marrow edema (BME) in patients with acute knee injuries, yet there are still limitations. Dual-energy CT, a possible viable replacement, is being explored (DECT).
METHODS: We systematically retrieved studies from EMBASE, Scopus, PUBMED, and the Cochrane Library and collected gray literatures. In accordance with the PRISMA-DTA standards, a systematic review was conducted between the study\'s initiation and July 31, 2021, utilizing an MRI reference standard and at least 10 adult patients with acute knee injuries to evaluate the diagnostic effectiveness of DECT for diagnosing BME. Two reviewers collected the study\'s details independently. For the meta-analysis, a bivariate mixed-effects regression model was utilized, and subgroup analysis was employed to determine the sources of variability.
RESULTS: The research included nine studies that examined 290 individuals between the ages of 23 and 53 with acute knee injuries who had DECT and MRI. Overall, the sensitivity, specificity, and AUC of the BME were 85% (95% confidence interval [CI]: 77-90%), 96% (95% CI: 93-97%), and 0.97 (95% CI: 0.95-0.98), respectively. To account for the assumed diversity of research, there were no statistically significant differences between the comparison groups in terms of specificity and sensitivity.
CONCLUSIONS: DECT is a viable alternative to MRI for individuals with acute knee injuries when MRI is inappropriate or unavailable.
METHODS: We systematically retrieved studies from EMBASE, Scopus, PUBMED, and the Cochrane Library and collected gray literatures. In accordance with the PRISMA-DTA standards, a systematic review was conducted between the study\'s initiation and July 31, 2021, utilizing an MRI reference standard and at least 10 adult patients with acute knee injuries to evaluate the diagnostic effectiveness of DECT for diagnosing BME. Two reviewers collected the study\'s details independently. For the meta-analysis, a bivariate mixed-effects regression model was utilized, and subgroup analysis was employed to determine the sources of variability.
RESULTS: The research included nine studies that examined 290 individuals between the ages of 23 and 53 with acute knee injuries who had DECT and MRI. Overall, the sensitivity, specificity, and AUC of the BME were 85% (95% confidence interval [CI]: 77-90%), 96% (95% CI: 93-97%), and 0.97 (95% CI: 0.95-0.98), respectively. To account for the assumed diversity of research, there were no statistically significant differences between the comparison groups in terms of specificity and sensitivity.
CONCLUSIONS: DECT is a viable alternative to MRI for individuals with acute knee injuries when MRI is inappropriate or unavailable.
摘要：
背景：膝关节损伤很普遍，早期诊断对指导临床治疗至关重要。MRI是急性膝关节损伤患者骨髓水肿（BME）的诊断金标准，但仍有局限性。双能CT,一个可能可行的替代品，正在探索（DECT）。
方法：我们系统地检索了EMBASE的研究，Scopus,pubmed,和Cochrane图书馆，并收集了灰色文献。根据PRISMA-DTA标准，在本研究开始至2021年7月31日之间,采用MRI参考标准和至少10例急性膝关节损伤成年患者进行了系统评价,以评估DECT诊断BME的诊断效能.两名审稿人独立收集了这项研究的细节。对于荟萃分析，采用双变量混合效应回归模型，亚组分析用于确定变异性的来源。
结果：该研究包括9项研究，对290名年龄在23至53岁之间的急性膝关节损伤患者进行了DECT和MRI检查。总的来说,灵敏度,特异性，BME的AUC为85％（95％置信区间[CI]：77-90％），96%（95%CI：93-97%），和0.97（95%CI：0.95-0.98），分别。考虑到假设的研究多样性，在特异性和敏感性方面,比较组间无统计学显著差异.
结论：当MRI不合适或无法获得时，DECT是一种可行的MRI替代方法。
方法：我们系统地检索了EMBASE的研究，Scopus,pubmed,和Cochrane图书馆，并收集了灰色文献。根据PRISMA-DTA标准，在本研究开始至2021年7月31日之间,采用MRI参考标准和至少10例急性膝关节损伤成年患者进行了系统评价,以评估DECT诊断BME的诊断效能.两名审稿人独立收集了这项研究的细节。对于荟萃分析，采用双变量混合效应回归模型，亚组分析用于确定变异性的来源。
结果：该研究包括9项研究，对290名年龄在23至53岁之间的急性膝关节损伤患者进行了DECT和MRI检查。总的来说,灵敏度,特异性，BME的AUC为85％（95％置信区间[CI]：77-90％），96%（95%CI：93-97%），和0.97（95%CI：0.95-0.98），分别。考虑到假设的研究多样性，在特异性和敏感性方面,比较组间无统计学显著差异.
结论：当MRI不合适或无法获得时，DECT是一种可行的MRI替代方法。
