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首页> 外文期刊>European spine journal >Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review
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Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review

机译：磁共振成像诊断成年腰痛或坐骨神经痛患者的腰椎病理：系统的诊断

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PurposeIn about 5% of all cases LBP is associated with serious underlying pathology requiring diagnostic confirmation and directed treatment. Magnetic resonance imaging (MRI) is often used for this diagnostic purpose yet its role remains controversial. Consequently, this review aimed to summarize the available evidence on the diagnostic accuracy of MRI for identifying lumbar spinal pathology in adult low back pain (LPB) or sciatica patients.MethodsMEDLINE, EMBASE and CINAHL were searched (until December 2009) for observational studies assessing the diagnostic accuracy of MRI compared to a reference test for the identification of lumbar spinal pathology. Two reviewers independently selected studies for inclusion, extracted data and assessed methodological quality. Pooled summary estimates of sensitivity and specificity with 95% confidence intervals were calculated for homogenous subsets of studies.ResultsEight studies were included in this review. Strata were defined for separate pathologies i.e. lumbar disc herniation (HNP) and spinal stenosis. Five studies comparing MRI to findings at the surgery for identifying HNP were included in a meta-analysis. Pooled analysis resulted in a summary estimate of sensitivity of 75% (95% CI 65–83%) and specificity of 77% (95% CI 61–88%). For spinal stenosis pooling was not possible.ConclusionsThe results suggest that a considerable proportion of patients may be classified incorrectly by MRI for HNP and spinal stenosis. However, the evidence for the diagnostic accuracy of MRI found by this review is not conclusive, since the results could be distorted due to the limited number of studies and large heterogeneity...
机译：目的在所有病例中，约有5％的LBP与需要诊断确认和定向治疗的严重基础病理有关。磁共振成像（MRI）通常用于此诊断目的，但其作用仍存在争议。因此，本综述旨在总结有关MRI诊断成人下腰痛（LPB）或坐骨神经痛患者的腰椎病理学诊断准确性的现有证据。方法检索MEDLINE，EMBASE和CINAHL（至2009年12月）以进行观察性研究以评估MRI的诊断准确性与用于确定腰椎病理的参考测试相比。两名审稿人独立选择纳入研究，提取数据并评估方法学质量。计算了均一的研究子集的敏感性和特异性汇总汇总估计值，置信区间为95％。结果本评价纳入了8项研究。为不同的病理学定义了分层，即腰椎间盘突出症（HNP）和椎管狭窄。荟萃分析包括五项将MRI与手术中发现HNP的发现进行比较的研究。汇总分析得出的敏感性汇总估计为75％（95％CI 65-83％），特异性为77％（95％CI 61-88％）。对于椎管狭窄，不可能合并。结论结果表明，MRI对HNP和椎管狭窄的患者分类可能不正确。然而，本综述所发现的MRI诊断准确性的证据尚无定论，因为由于研究数量有限和异质性较大，结果可能会失真。

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