3.0 T MRI is more recommended to detect acetabular labral tears than MR Arthrography: an updated meta-analysis of diagnostic accuracy

Background: This meta-analysis aimed to evaluate the current evidence on the diagnostic performance of MRI/MRA for detecting acetabular labral tears (ALT).

Methods: We systematically searched the PubMed, Embase, and Cochrane library until February 5, 2021, to identify original research studies reporting the diagnostic performance of MRI/MRA for the detection of ALT. Study methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. The summary sensitivity (Se) and specificity (Sp) of the studies were estimated using a bivariate model. We calculated the post-test probability to assess the clinical utility of MRI/MRA. Univariate meta-regression and subgroup analyses were performed to assess between-study heterogeneity.

Results: We included 22 studies (n = 1670 patients). The meta-analytic summary Se and Sp for MRI were 0.8 (95% CI 0.51-0.94) and 0.77 (95% CI 0.68-0.84), respectively, while for MRA they were 0.89 (95% CI 0.82-0.93) and 0.69 (95% CI 0.56-0.80). MRA showed a higher area under the summary receiver operating curve (SROC) (0.87 vs. 0.80) than MRI. MRI could increase the post-test probability to 0.78 and could decrease the post-test probability to 0.21, MRA could increase the post-test probability to 0.74 and could decrease the post-test probability to 0.14. Meta-regression analysis showed two significant factors affecting study heterogeneity: MR field strength and reference standard. After dividing the studies into two subgroups based on the MR field strength, we found that the Se values of 3.0 T MRI were very close to MRA (0.87 vs. 0.89), the Sp values of 3.0 T MRI were superior to MRA (0.77 vs. 0.69).

Conclusions: Given that 3.0 T MRI could provide a non-invasive, fast and convenient method to recognize suspicious ALT cases, 3.0 T MRI is more recommended than MRA.