Objective To investigate the diagnostic accuracy of MRI for identifying posterior element bone stress injury (PEBSI) in the athletic population with low back pain (LBP). Study Design A systematic review searched for published sources up until July 2020. Eligibility criteria: prospective cohort design, MRI diagnosis, adolescents/young adults, chief symptoms of LBP, PEBSI as the clinical diagnosis and SPECT-CT as reference standard. Risk of bias and overall quality were assessed using QUADAS-2 and GRADE, respectively. A narrative synthesis was conducted. Results Four studies were included, with three included in the quantitative synthesis. Compared with SPECT-CT, two studies involving MRI demonstrated sensitivity and specificity of 80% and 100%, and 88% and 97%, respectively. Compared with CT, one study involving MRI demonstrated sensitivity and specificity of 97% and 91%, respectively. Risk of bias was moderate to high although consistency across studies was noted. Conclusion Findings support further research to consider MRI as the modality of choice for diagnosing PEBSI. MRI was consistent with SPECT-CT for ruling-in PEBSI, but the clinical value of cases where MRI had false negatives remains uncertain due to possible over-sensitivity by SPECT-CT. PROSPERO registration number CRD42015023979.

中文翻译：

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MRI诊断下腰痛运动员后牙骨应力损伤的诊断准确性：系统评价和叙述性综合

目的探讨MRI在运动型下腰痛（LBP）人群中鉴定后元素骨应力损伤（PEBSI）的诊断准确性。研究设计一项系统评价对直到2020年7月的已发表文献进行搜索。入选标准：前瞻性队列设计，MRI诊断，青少年/年轻人，LBP的主要症状，以PEBSI作为临床诊断，以SPECT-CT作为参考标准。分别使用QUADAS-2和GRADE评估了偏倚风险和整体质量。进行叙述性合成。结果纳入四项研究，其中三项纳入定量综合。与SPECT-CT相比，两项涉及MRI的研究表明敏感性和特异性分别为80％和100％，88％和97％。与CT相比 一项涉及MRI的研究表明敏感性和特异性分别为97％和91％。尽管注意到研究之间的一致性，偏倚的风险是中度到高度。结论结论支持进一步的研究以将MRI作为诊断PEBSI的首选方式。MRI与PEECT的SPECT-CT一致，但由于SPECT-CT可能会引起过度敏感性，因此MRI阴性的病例的临床价值仍不确定。PROSPERO注册号CRD42015023979。但由于SPECT-CT可能会导致过度敏感，因此MRI阴性的病例的临床价值仍不确定。PROSPERO注册号CRD42015023979。但由于SPECT-CT可能会导致过度敏感，因此MRI阴性的病例的临床价值仍不确定。PROSPERO注册号CRD42015023979。