[Quantitative evaluation for diagnostic efficacy of computed tomography and magnetic resonance imaging in patients with lumbar disc herniation].

ABSTRACT

OBJECTIVE: To evaluate the diagnostic performances of CT and MRI in patients with lumbar intervertebral disc herniation through the Meta analytical method. METHOD: The relevant English and Chinese articles published between 1980 and 2010 were searched in PubMed, Medline, Ovid database, Cochrane library and Chinese Periodical Web. According to the criteria for diagnostic researches published by Cochrane Method Group on Screening and Diagnostic Tests, each article was critically appraised and screened with regards to the absolute numbers of true-positive, false-negative, true-negative and false-positive. Statistical analysis was performed by the Meta-Disc version 1.4, SPSS 13.0 and Comprehensive Meta-analysis version II. Heterogeneity was tested and publication bias analyzed. And the pooled weighted sensitivity and specificity and the corresponding 95%CI were calculated. The summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) calculated to summarize and evaluate the diagnostic efficiency of CT and MRI in lumbar intervertebral disc herniation. Finally a sensitivity analysis was performed. RESULTS: According to the criteria of internalization, 9 articles were included. Among them, the themes were CT (n = 3), MRI (n = 3) and CT & MRI (n = 3). Eight was prospectively studied and one retrospectively. At the diagnosis of lumbar intervertebral disc herniation, the pooled weighted sensibility and specificity and 95% confidence interval and area under SROC curve for CT to the lumbar intervertebral disc herniation was 0.73 (0.68 - 0.77), 0.78 (0.72 - 0.82) and 83.5% respectively. The MRI was 0.88 (0.83 - 0.91), 0.79 (0.71 - 0.87) and 88.8% respectively. There was statistically significant difference in the pooled weighted sensibility (P < 0.05); No statistically significant difference was found in the pooled weighted specificity (P > 0.05); And there was statistically significant difference in the AUC curve (P < 0.05). CONCLUSION: After a meta-analysis of the diagnostic value of CT and MRI for the lumbar intervertebral disc herniation, MRI is more accurate than CT in the diagnosis of lumbar intervertebral disc herniation.