We aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting bone marrow edema (BME) in patients with lower limb joint injuries. A thorough literature search was conducted across the PubMed, Embase, and Web of Science databases to identify relevant studies up to April 2024. Studies examining the diagnostic performance of DECT in detecting BME in lower limb joint injuries patients were included. Sensitivity and specificity were evaluated using the inverse variance method and transformed via the Freeman-Tukey double arcsine transformation. Furthermore, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the methodological quality of the included studies. This meta-analysis included 17 articles involving 625 patients. The pooled sensitivity, specificity, and AUC for DECT in detecting BME in lower limb joint injuries patients were 0.82 (95 % CI: 0.76–0.87), 0.95 (95 % CI: 0.92–0.97), and 0.95 (95 % CI: 0.93–0.97), respectively. The pooled sensitivity of DECT for detecting BME in knee, hip, and ankle joint injuries was 0.80, 0.84, and 0.80, with no significant difference among these joints ( = 0.55). The pooled specificity for knee, hip, and ankle injuries was 0.95, 0.97, and 0.89. Specificity differed significantly among the joints ( < 0.01), with the highest specificity in hip injuries. Our meta-analysis indicates that DECT demonstrates high diagnostic performance in detecting BME in patients with lower limb joint injuries, with the highest specificity observed in hip joint injuries. To validate these findings, further larger prospective studies are necessary.

中文翻译：

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双能CT对下肢关节损伤骨髓水肿诊断性能的Meta分析


我们的目的是评估双能计算机断层扫描 (DECT) 在检测下肢关节损伤患者骨髓水肿 (BME) 方面的诊断性能。我们在 PubMed、Embase 和 Web of Science 数据库中进行了彻底的文献检索，以识别截至 2024 年 4 月的相关研究。其中包括检查 DECT 在检测下肢关节损伤患者 BME 方面的诊断性能的研究。使用逆方差方法评估灵敏度和特异性，并通过 Freeman-Tukey 双反正弦变换进行变换。此外，利用诊断准确性研究质量评估-2 (QUADAS-2) 工具来评估纳入研究的方法学质量。这项荟萃分析包括 17 篇文章，涉及 625 名患者。 DECT 检测下肢关节损伤患者 BME 的汇总敏感性、特异性和 AUC 分别为 0.82 (95% CI: 0.76–0.87)、0.95 (95% CI: 0.92–0.97) 和 0.95 (95% CI: 0.93) –0.97），分别。 DECT 检测膝关节、髋关节和踝关节损伤 BME 的汇总灵敏度分别为 0.80、0.84 和 0.80，这些关节之间没有显着差异 (= 0.55)。膝关节、髋关节和踝关节损伤的汇总特异性分别为 0.95、0.97 和 0.89。各关节之间的特异性差异显着 (< 0.01)，其中髋部损伤的特异性最高。我们的荟萃分析表明，DECT 在检测下肢关节损伤患者的 BME 方面表现出较高的诊断性能，其中在髋关节损伤中观察到的特异性最高。为了验证这些发现，需要进一步进行更大规模的前瞻性研究。