Guo Yang, Parthasarathy Sudharshan, Goyal Preeya, McCarthy Robert J, Larson Andrew C, Miller Frank H
Department of Radiology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago, IL, 60611, USA.
Abdom Imaging. 2015 Apr;40(4):818-34. doi: 10.1007/s00261-014-0137-6.
Elastography is a non-invasive method to quantify fibrosis based on tissue mechanical properties. We performed a meta-analysis to assess the diagnostic accuracy of two such techniques: Acoustic Radiation Force Impulse Imaging (ARFI) or Magnetic Resonance Elastography (MRE) for staging hepatic fibrosis.
Literature databases were searched until June 2013. Inclusion criteria were evaluation of MRE or ARFI, liver biopsy, and reported sensitivity and specificity. A random effects model was used to combine sensitivity and specificity, from which positive (LR+) and negative (LR-) likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristics curve (AUROC) were derived. Differences between MRE and ARFI were compared with t tests (P < 0.05 considered significant).
Eleven MRE studies including 982 patients and fifteen ARFI studies including 2,128 patients were selected. AUROC for MRE staging fibrosis were 0.94, 0.97, 0.96, and 0.97 for F1-F4, respectively, whereas AUROC for ARFI staging were 0.82, 0.85, 0.94, and 0.94 for F1-F4, respectively. Significance was found in AUROC between MRE and ARFI for the diagnosis of stage 1 and 2 fibrosis.
MRE is more accurate than ARFI with a higher combination of sensitivity, specificity, LR, and AUROC particularly in diagnosing early stages of hepatic fibrosis.
弹性成像技术是一种基于组织力学特性对纤维化进行定量分析的非侵入性方法。我们进行了一项荟萃分析，以评估两种此类技术——声辐射力脉冲成像（ARFI）或磁共振弹性成像（MRE）在肝纤维化分期中的诊断准确性。
检索文献数据库至2013年6月。纳入标准为对MRE或ARFI、肝活检的评估，以及报告的敏感性和特异性。采用随机效应模型合并敏感性和特异性，由此得出阳性（LR+）和阴性（LR-）似然比、诊断比值比以及受试者操作特征曲线下面积（AUROC）。采用t检验比较MRE和ARFI之间的差异（P < 0.05认为具有显著性）。
选择了11项包含982例患者的MRE研究以及15项包含2128例患者的ARFI研究。MRE对F1 - F4期纤维化分期的AUROC分别为0.94、0.97、0.96和0.97，而ARFI对F1 - F4期纤维化分期的AUROC分别为0.82、0.85、0.94和0.94。在诊断1期和2期纤维化时，MRE和ARFI的AUROC存在显著性差异。
MRE比ARFI更准确，在敏感性、特异性、似然比和AUROC方面具有更高的综合表现，尤其是在诊断肝纤维化早期阶段。
