Diagnostic performance of ankle ultrasound for diagnosing anterior talofibular and calcaneofibular ligament injuries: a meta-analysis

2019 ◽  
Vol 61 (5) ◽  
pp. 651-661
Author(s):  
Hosik Seok ◽  
Sun Hwa Lee ◽  
Seong Jong Yun
Keyword(s):  
Subgroup Analysis ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Summary Receiver Operating Characteristic ◽  
Calcaneofibular Ligament ◽  
Ligament Tear ◽  
Tibiofibular Ligament ◽  
Ankle Ultrasound

Background Ankle ultrasound imaging could be an option with higher priority due to its lack of radiation, and cost- and time-effectiveness. However, previous studies regarding anterior tibiofibular ligament and calcaneofibular ligament injuries have shown varied results. Purpose To evaluate the diagnostic performance of ankle ultrasound for anterior tibiofibular ligament and calcaneofibular ligament injuries. Material and Methods PubMed and EMBASE databases were searched for diagnostic accuracy studies that used ultrasound for diagnosing anterior tibiofibular ligament and calcaneofibular ligament injuries. Bivariate and hierarchical summary receiver operating characteristic modeling were used to evaluate diagnostic performance. Subgroup analysis was performed using studies according to severity of the injury (complete and partial anterior tibiofibular ligament tear). We performed meta-regression analyses for heterogeneity exploration. Results Ten articles involving a total of 380 patients were included. For anterior tibiofibular ligament injury, the summary sensitivity, summary specificity, and area under the hierarchical summary receiver operating characteristic curve (AUC) were 0.99, 0.92, and 0.99, respectively. For calcaneofibular ligament injury, the summary sensitivity, summary specificity, and AUC were 0.95, 0.99, and 0.95, respectively. In subgroup analysis, for complete anterior tibiofibular ligament tear, the summary sensitivity, summary specificity, and AUC were 0.96, 0.82, and 0.96, respectively. For partial anterior tibiofibular ligament tear, the summary sensitivity, summary specificity, and AUC were 0.90, 0.82, and 0.93, respectively. Among the various potential covariates, proportion of anterior tibiofibular ligament tear, ultrasound interpreter, and reference standard were associated with specificity heterogeneity. Conclusion Ankle ultrasound demonstrates high diagnostic performance in the diagnosis of anterior tibiofibular ligament and calcaneofibular ligament injuries. We recommend ultrasound performed by a musculoskeletal radiologist as a first-line diagnostic tool to diagnose anterior tibiofibular ligament and calcaneofibular ligament injuries.

Diagnostic Performance of Magnetic Resonance Imaging for Detecting Meniscal Ramp Lesions in Patients With Anterior Cruciate Ligament Tears: A Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (8) ◽  
pp. 2051-2059 ◽  
Author(s):  
Boyeon Koo ◽  
Sun Hwa Lee ◽  
Seong Jong Yun ◽  
Jae Gwang Song
Keyword(s):  
Systematic Review ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Summary Receiver Operating Characteristic ◽  
Acl Tear ◽  
Knee Position ◽  
Ramp Lesion ◽  
Anterior Cruciate

Background: The clinical importance of meniscal ramp lesions in patients with anterior cruciate ligament (ACL) tear has emerged as a major issue. However, the diagnostic accuracy of magnetic resonance imaging (MRI) for detecting ramp lesions has a wide range. Purpose: To perform a systematic review and meta-analysis of the diagnostic performance of MRI for diagnosing ramp lesion in patients with ACL tear. Study Design: Systematic review and meta-analysis. Methods: A literature search of PubMed, EMBASE, and the Cochrane Library was performed based on the revised guidelines for the PRISMA DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Accuracy Studies) statement. Diagnostic performance studies using MRI as the index test and arthroscopy as the reference standard for ramp lesion were included. Bivariate and hierarchical summary receiver operating characteristic modeling was used to evaluate the diagnostic performance. Meta-regression analyses were performed to identify potential sources of heterogeneity. Results: The review and meta-analysis included 9 studies from 8 articles (883 patients with ACL tear and reconstruction). The summary sensitivity, summary specificity, and area under the hierarchical summary receiver operating characteristic for ramp lesion were 0.71 (95% CI, 0.59-0.81), 0.94 (95% CI, 0.88-0.97), and 0.90 (95% CI, 0.87-0.92), respectively. Among the potential covariates, magnet strength ( P < .01), patient knee position ( P = .04), and MRI interpreter ( P = .04) were associated with heterogeneity in terms of sensitivity, whereas magnet strength ( P = .03) was associated with heterogeneity in terms of specificity. Conclusion: MRI demonstrated moderate sensitivity and excellent specificity for diagnosing ramp lesion. Routine arthroscopic assessment is recommended for the presence of ramp lesion, regardless of whether it is suspected on MRI. Further clinicoradiological studies of diagnostic algorithms are needed for identifying ramp lesion, including high-resolution MRI with appropriate knee position.

The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers

2007 ◽  
Vol 35 (7) ◽  
pp. 1070-1074 ◽  
Author(s):  
Nicolas Pujol ◽  
Marie Philippe Rousseaux Blanchi ◽  
Pierre Chambat
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Injury Rates ◽  
Anterior Cruciate Ligament Injuries ◽  
Alpine Skiers ◽  
Anterior Cruciate

Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.

scholarly journals Are sniffer dogs a reliable approach for diagnosing SARS-CoV-2 infection?

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Brandon M. Henry
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Pooled Analysis ◽  
Diagnostic Efficiency ◽  
Diagnostic Specificity ◽  
Summary Receiver Operating Characteristic ◽  
Electronic Search ◽  
Individual Variations ◽  
Infected Material

Abstract Objectives Despite inter-individual variations in their diagnostic efficiency, dogs have been trained to investigate many human pathologies, especially cancer, diabetes, migraine, seizures and even infectious diseases. To this end, we performed a critical review and pooled analysis of current scientific literature on the performance of dogs trained for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive human specimens. Methods We carried out an electronic search in PubMed, Scopus and Web of Science with the keywords “dog(s)” AND “sniffer” OR “scent” OR “smell” AND “SARS-CoV-2” OR “severe acute respiratory syndrome coronavirus 2” OR “coronavirus disease 2019” OR “COVID-19” within all fields, without date or language restrictions, to identify studies describing dogs’ performance for identifying SARS-CoV-2 infected material. Results Three studies could be finally included in pooled analysis, totaling 17 dogs (47% females), aged between 0.5 and 12 years. The pooled diagnostic sensitivity was 0.88 (95% CI, 0.84–0.91; I 2, 85.3%), the diagnostic specificity 0.99 (95% CI, 0.99–0.99; I 2, 97.4%), whilst the area under the summary receiver operating characteristic curve (SROC) was 0.979 (standard error, 0.003). Conclusions The notable performance observed in this pooled analysis would persuade us to suggest that adequately trained dogs could represent an intriguing and sustainable resource for purposes of rapid SARS-CoV-2 mass screening.

scholarly journals Perbandingan Kriteria ACR-1997 dan SLICC-2012 dalam Diagnosis Lupus Eritematosus Sistemik pada Anak

Sari Pediatri ◽  
2021 ◽  
Vol 22 (6) ◽  
pp. 386
Author(s):  
Dwi Lestari Pramesti ◽  
Dina Muktiarti
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Systemic Lupus ◽  
Summary Receiver Operating Characteristic ◽  
American College Of Rheumatology ◽  
Review Manager ◽  
Receiver Operating

Latar belakang. Lupus eritematosus sistemik merupakan penyakit autoimun sistemik pada jaringan ikat yang bersifat kronik dan progresif, terutama pada anak. Hingga saat ini belum ada diagnosis baku emas, sehingga untuk menegakkan diagnosis dapat menggunakan kriteria The American College of Rheumatology (ACR) tahun 1997 atau The Systemic Lupus International Collaborating Clinics (SLICC) tahun 2012.Tujuan. Mengumpulkan bukti ilmiah perbandingan penggunaan kriteria ACR-1997 dan SLICC-2012 dalam diagnosis lupus eritematosus sistemik pada anak.Metode. Penelusuran literatur secara sistematis secara daring melalui database Pubmed dan Cochrane. Analisis dilakukan menggunakan Review Manager dan model hierarchical summary receiver operating characteristic (HSROC) pada studi meta-analsiis. Kualitas studi dinilai dengan QUADAS-2.Hasil. Satu artikel telaah sistematis dan meta-analisis dan satu artikel studi longitudinal dilakukan telaah kritis. Kualitas kedua studi dinilai baik. Studi oleh Hartman dkk menunjukkan kriteria ACR-1997 lebih dianjurkan sebagai kriteria klasifikasi LES pada anak karena lebih spesifik (94,1% vs 82%) dan menghindari terjadinya positif palsu. Studi kedua oleh Lythgoe dkk menunjukkan SLICC-2012 lebih sensitif (92,9% vs 84,1%) dan secara lebih dini mengklasifikasi pasien anak dengan LES.Kesimpulan. Kriteria SLICC-2012 memiliki sensitivitas yang lebih tinggi dalam klasifikasi LES pada anak tetapi memiliki spesifisitas yang lebih rendah dibandingkan ACR-1997. Namun, SLICC-2012 dapat mengklasifikasi LES lebih dini secara signifikan dibandingkan ACR-1997.

scholarly journals Diagnostic Performance of CMR, SPECT, and PET Imaging for the Identification of Coronary Artery Disease: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianfeng Xu ◽  
Fei Cai ◽  
Changran Geng ◽  
Zheng Wang ◽  
Xiaobin Tang
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
Emission Computed Tomography ◽  
Artery Disease

Background: Myocardial perfusion imaging modalities, such as cardiac magnetic resonance (CMR), single-photon emission computed tomography (SPECT), and positron emission tomography (PET), are well-established non-invasive diagnostic methods to detect hemodynamically significant coronary artery disease (CAD). The aim of this meta-analysis is to compare CMR, SPECT, and PET in the diagnosis of CAD and to provide evidence for further research and clinical decision-making.Methods: PubMed, Web of Science, EMBASE, and Cochrane Library were searched. Studies that used CMR, SPECT, and/or PET for the diagnosis of CAD were included. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with their respective 95% confidence interval, and the area under the summary receiver operating characteristic (SROC) curve were calculated.Results: A total of 203 articles were identified for inclusion in this meta-analysis. The pooled sensitivity values of CMR, SPECT, and PET were 0.86, 0.83, and 0.85, respectively. Their respective overall specificity values were 0.83, 0.77, and 0.86. Results in subgroup analysis of the performance of SPECT with 201Tl showed the highest pooled sensitivity [0.85 (0.82, 0.88)] and specificity [0.80 (0.75, 0.83)]. 99mTc-tetrofosmin had the lowest sensitivity [0.76 (0.67, 0.82)]. In the subgroup analysis of PET tracers, results indicated that 13N had the lowest pooled sensitivity [0.83 (0.74, 0.89)], and the specificity was the highest [0.91 (0.81, 0.96)].Conclusion: Our meta-analysis indicates that CMR and PET present better diagnostic performance for the detection of CAD as compared with SPECT.

scholarly journals Accuracy of Flow-void Diameters on MR Images in Diagnosing Uterine Arteriovenous Malformations in Patients With Pregnancy-related Diseases

2021 ◽  
Author(s):  
Hui-zhu Chen ◽  
Fu-min Zhao ◽  
Ling-jun Liu ◽  
Xiao-hui Dai ◽  
Xue-sheng Li ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Study Design ◽  
Arteriovenous Malformations ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Diagnostic Efficiency ◽  
Noninvasive Method ◽  
Mr Images ◽  
Receiver Operating Characteristic Curves ◽  
Flow Void

Abstract Objective(s): To evaluate the “flow void” diameter in patients with pregnancy-related diseases with and without uterine AVMs and assess the diagnostic performance of unenhanced MRI for uterine AVMs.Study Design: From May 2014 to April 2019, 79 patients with pregnancy-related diseases were included, including 36 with and 43 without uterine AVMs confirmed by DSA. On MRI, the diameter of the most prominent “flow void” (hereinafter referred to as fv-D) was measured and compared between patients with and without uterine AVMs. The diagnostic performance of fv-D was estimated with receiver operating characteristic curves.Results: The “flow void” sign was observed in patients with and without uterine AVMs (P>0.05). The fv-D was significantly larger in patients with uterine AVMs in the myometrium and parametrium than in patients without uterine AVMs (P<0.0001). The fv-D achieved a reliable diagnostic performance in the myometrium (sensitivity: 80.56%, specificity: 60.27%, AUC: 0.727, cut-off:>1.33 mm) and parametrium (sensitivity: 97.22%, specificity: 67.44%, AUC: 0.881, cut-off:>2.6 mm). Conclusions: On MRI, fv-D could diagnose uterine AVMs. The fv-D had a much higher diagnostic efficiency in the parametrium than in the myometrium. The parametrium fv-D greatly improved the diagnostic sensitivity and provides a more accurate, noninvasive method of investigating possible uterine AVMs.

scholarly journals Comprehensive and Integrative Analysis Reveals the Diagnostic, Clinicopathological and Prognostic Significance of Polo-Like Kinase 1 in Hepatocellular Carcinoma

2018 ◽  
Vol 47 (3) ◽  
pp. 925-947 ◽  
Author(s):  
Peng Lin ◽  
Dong-yue Wen ◽  
Yi-wu Dang ◽  
Yun He ◽  
Hong Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Cycle ◽  
Liver Cancer ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Summary Receiver Operating Characteristic ◽  
Operating Characteristic Curve ◽  
Standardized Mean Difference

Background/Aims: Liver cancer has the second highest cancer-related death rate globally and has relatively few targeted therapeutics. Polo-like kinase 1 (PLK1) is a fascinating trigger of the cell cycle; however, the still-rudimentary understanding of PLK1 at present is a significant barrier to its clinical applications. Here, we comprehensively clarified the clinicopathological value and potential functions of PLK1 in hepatocellular carcinoma (HCC). Methods: HCC-related microarrays, RNA-sequencing datasets and published studies were deeply mined and integrated from The Cancer Genome Atlas, Gene Expression Omnibus, ArrayExpress, Oncomine, literature databases, and immunohistochemistry experiments. Meanwhile, the associations between PLK1 expression and its clinicopathological implications and prognostic value in HCC patients were assessed. The standardized mean difference, summary receiver operating characteristic curve and the corresponding area under the curve, hazard ratios, odds ratios (ORs), and their 95% confidence intervals (CIs) were examined by STATA 12.0. Additionally, several bioinformatics methods were used to identify the potential function of PLK1 in HCC. Results: Comprehensive analyses revealed that PLK1 was significantly increased in HCC (standardized mean difference = 1.34, 95% CI: 1.03–1.65, P < 0.001). The results of diagnostic tests specified that in the summary receiver operating characteristic curve, the area under the curve was 0.88 (95% CI: 0.85–0.90). Furthermore, an elevated PLK1 level significantly predicted unfavorable overall survival (hazard ratio = 1.78, 95% CI: 1.10–2.88, P = 0.019) and was correlated with female gender (OR = 0.73, 95% CI: 0.56–0.95, P = 0.017), tumor thrombus (OR = 3.97, 95% CI: 1.46–10.78, P < 0.001), metastasis (OR = 3.46, 95% CI: 1.33–9.01, P = 0.011), pathologic stage (OR = 1.56, 95% CI: 1.17–2.07, P = 0.002), Barcelona Clinic Liver Cancer stage (OR = 5.76, 95% CI: 2.17–15.28, P < 0.001) and histologic grade (OR = 2.33, 95% CI: 1.12–487, P = 0.024). Through bioinformatics methods, we determined that enhancing the proliferative effect of PLK1 in HCC was associated with a series of hub genes and the activation of the cell cycle pathway. Conclusions: These findings substantiated that PLK1 may be an independent prognostic biomarker in HCC and may facilitate the development of targeted precision oncology.

Knee Joint Response to Compressive Loading and Ligament Injury

1999 ◽  
Author(s):  
Jordan Lee ◽  
Frank Fronczak
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
Compressive Loading ◽  
Degree Of Freedom ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Acl Injuries ◽  
Measuring Machine ◽  
Anterior Cruciate ◽  
Six Degree Of Freedom

Abstract The knee joint is a six degree-of-freedom joint which has a complex response to loading. The joint has a characteristic behavior for particular ligament injuries such as anterior cruciate ligament failure. The response of the joint to a combination of compressive loading and secondary loadings was examined in this study. The secondary loadings were: an anterior force, a valgus moment, an internal torque, or an external torque. A goat model was used with 17 specimens testing different ligament injuries in vitro, specifically stretched or severed anterior cruciate ligaments (ACL) and lateral collateral ligaments (LCL). The femur was held fixed and the tibia loaded in a specially designed apparatus, allowing complete six degree-of-freedom joint motion. The motion of the tibia with respect to the femur was recorded using a coordinate measuring machine. The knee joint demonstrated sensitivity to ACL injuries but not to LCL injuries for the loadings examined. The response to ACL injuries was more highly dependant on the compressive load than the secondary loadings for all tests.

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