Diagnostic accuracy of contrast and non-contrast 1.5 tesla magnetic resonance imaging for lumbar herniated nucleus pulposus based on surgical findings: A systematic review and meta-analysis of diagnostic test accuracy studies

This study aims to provide the latest information regarding the accuracy of contrast and non-contrast 1.5 Tesla MRI in the diagnosis of lumbar Herniated Nucleus Pulposus (HNP) compared with surgical findings. We included studies with subjects diagnosed with lumbar HNP due to degenerative processes, preoperative 1.5 Tesla contrast, and non-contrast MRI and described the number of findings of MRI diagnostic tests (index test) on the actual conditions found during surgery (reference standard). We searched literature from 5 databases: ProQuest, Pubmed, Cochrane Library, Biomed Central, and ScienceDirect. The sensitivity and specificity of contrast and non-contrast 1.5 Tesla MRI ranged between 64-95% and 55-100% (95% CI) with the area under the curve above the threshold on the ROC curve. Two studies compared the accuracy of MRI and Computed Tomography (CT) myelography with a wider ROC curve on CT myelography than on MRI. The ROC curve which has a wide area under the curve above the threshold depicts the relationship between sensitivity and specificity, shows that contrast non-contrast 1.5 Tesla MRI has a good accuracy in HNP diagnostic.