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Review
. 2023 Jan 6:9:1020766.
doi: 10.3389/fsurg.2022.1020766. eCollection 2022.

Value of imaging examinations in diagnosing lumbar disc herniation: A systematic review and meta-analysis

Zhihao Huang  1 , Pengfei Zhao  2 , Chengming Zhang  3 , Jingtao Wu  4 , Ruidong Liu  5
Affiliations
Review

Value of imaging examinations in diagnosing lumbar disc herniation: A systematic review and meta-analysis

Zhihao Huang et al. Front Surg. .

Abstract

Purpose: To systematically review the clinical value of three imaging examinations (Magnetic Resonance Imaging, Computed Tomography, and myelography) in the diagnosis of Lumbar Disc Herniation.

Methods: Databases including PubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP were electronically searched to collect relevant studies on three imaging examinations in the diagnosis of Lumbar Disc Herniation from inception to July 1, 2021. Two reviewers using the Quality Assessment of Diagnostic Accuracy Studies-2 tool independently screened the literature, extracted the data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Meta-DiSc 1.4 software and Stata 15.0 software.

Results: A total of 38 studies from 19 articles were included, involving 1,875 patients. The results showed that the pooled Sensitivity, pooled Specificity, pooled Positive Likelihood Ratio, pooled Negative Likelihood Ratio, pooled Diagnostic Odds Ratio, Area Under the Curve of Summary Receiver Operating Characteristic, and Q* were 0.89 (95%CI: 0.87-0.91), 0.83 (95%CI: 0.78-0.87), 4.57 (95%CI: 2.95-7.08), 0.14 (95%CI: 0.09-0.22), 39.80 (95%CI: 18.35-86.32), 0.934, and 0.870, respectively, for Magnetic Resonance Imaging. The pooled Sensitivity, pooled Specificity, pooled Positive Likelihood Ratio, pooled Negative Likelihood Ratio, pooled Diagnostic Odds Ratio, Area Under the Curve of Summary Receiver Operating Characteristic, and Q* were 0.82 (95%CI: 0.79-0.85), 0.78 (95%CI: 0.73-0.82), 3.54 (95%CI: 2.86-4.39), 0.19 (95%CI: 0.12-0.30), 20.47 (95%CI: 10.31-40.65), 0.835, and 0.792, respectively, for Computed Tomography. The pooled Sensitivity, pooled Specificity, pooled Positive Likelihood Ratio, pooled Negative Likelihood Ratio, pooled Diagnostic Odds Ratio, Area Under the Curve of Summary Receiver Operating Characteristic, and Q* were 0.79 (95%CI: 0.75-0.82), 0.75 (95%CI: 0.70-0.80), 2.94 (95%CI: 2.43-3.56), 0.29 (95%CI: 0.21-0.42), 9.59 (95%CI: 7.05-13.04), 0.834, and 0.767 respectively, for myelography.

Conclusion: Three imaging examinations had high diagnostic value. In addition, compared with myelography, Magnetic Resonance Imaging had a higher diagnostic value.

Keywords: Computed Tomography; Lumbar Disc Herniation; Magnetic Resonance Imaging; meta-analysis; myelography.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of literature search and selction process.
Figure 2
Figure 2
Risk of bias and applicability concerns graph.
Figure 3
Figure 3
Risk of bias and applicability concerns summary.
Figure 4
Figure 4
Forest plot of MRI for the diagnosis of LDH. The subgraph of (A–F) refers to Sen, Spe, +LR, −LR, DOR, AUC and Q*, respectively.
Figure 5
Figure 5
The sensitivity analysis of MRI.
Figure 6
Figure 6
Funnel plot of MRI for the diagnosis of LDH.
Figure 7
Figure 7
Forest plot of CT for the diagnosis of LDH. The subgraph of (A–F) refers to Sen, Spe, +LR, −LR, DOR, AUC and Q*, respectively.
Figure 8
Figure 8
The sensitivity analysis of CT.
Figure 9
Figure 9
Funnel plot of CT for the diagnosis of LDH.
Figure 10
Figure 10
Forest plot of myelography for the diagnosis of LDH. The subgraph of (A–F) refers to Sen, Spe, +LR, −LR, DOR, AUC and Q*, respectively.
Figure 11
Figure 11
The sensitivity analysis of myelography.
Figure 12
Figure 12
Funnel plot of myelography for the diagnosis of LDH.
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