超顺磁性氧化铁增强磁共振成像用于肝脏局灶性病变：系统评价与荟萃分析。

Superparamagnetic iron oxide-enhanced magnetic resonance imaging for focal hepatic lesions: systematic review and meta-analysis.

作者信息

Li You-Wei, Chen Zheng-Guang, Wang Ji-Chen, Zhang Zong-Ming

机构信息

You-Wei Li, Department of Radiology, Beijing Chuiyangliu Hospital Affiliated to School of Medicine, Tsinghua University, Beijing 100022, China.

出版信息

World J Gastroenterol. 2015 Apr 14;21(14):4334-44. doi: 10.3748/wjg.v21.i14.4334.

DOI:10.3748/wjg.v21.i14.4334

PMID:25892885

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4394096/

Abstract

AIM

To evaluate the performance of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the detection and characterization of focal hepatic lesions (FHLs).

METHODS

This meta-analysis compared relevant studies that were identified by searching PubMed, EMBASE, and the Cochrane Library databases for articles published between January 1988 and September 2014 and that met the following criteria: (1) SPIO-enhanced MRI was conducted to identify FHLs and data were sufficient for pooled analysis using Meta-DiSc 1.4; (2) hepatocellular carcinomas (HCCs) were differentiated from other FHLs; (3) well-differentiated HCCs (WD-HCCs) were contradistinguished from dysplastic nodules; and (4) WD-HCCs were compared with moderately and poorly differentiated HCCs (MD- and PD-HCCs, respectively).

RESULTS

The data obtained from 15 eligible studies yielded a sensitivity of 85% and a specificity of 78% for differentiating between HCCs and other FHLs. The sensitivity was unchanged and the specificity was increased to 87% when non-HCC malignancies were excluded. Comparative analyses between WD-HCCs and MD- and PD-HCCs from seven studies showed a sensitivity of 98% and a specificity of 50% for the diagnosis of MD- and PD-HCCs, and the area under the summary receiver operating characteristics (sROC) curve was 0.97. A comparison between WD-HCCs and dysplastic nodules revealed a sensitivity of 50% and a specificity of 92% for the diagnosis of WD-HCCs and the area under the sROC curve was 0.80.

CONCLUSION

SPIO-enhanced MRI is useful in differentiating between HCCs and other FHLs.

摘要

目的

评估超顺磁性氧化铁（SPIO）增强磁共振成像（MRI）在检测和鉴别肝脏局灶性病变（FHL）中的性能。

方法

本荟萃分析比较了通过检索PubMed、EMBASE和Cochrane图书馆数据库，筛选出的1988年1月至2014年9月期间发表的符合以下标准的相关研究：（1）进行了SPIO增强MRI以识别FHL，且数据足以使用Meta-DiSc 1.4进行汇总分析；（2）肝细胞癌（HCC）与其他FHL相鉴别；（3）高分化HCC（WD-HCC）与发育异常结节相区分；（4）将WD-HCC与中分化和低分化HCC（分别为MD-HCC和PD-HCC）进行比较。

结果

从15项符合条件的研究中获得的数据显示，鉴别HCC与其他FHL的敏感性为85%，特异性为78%。排除非HCC恶性肿瘤后，敏感性不变，特异性提高到87%。来自7项研究的WD-HCC与MD-HCC和PD-HCC的比较分析显示，诊断MD-HCC和PD-HCC的敏感性为98%，特异性为50%，汇总受试者工作特征（sROC）曲线下面积为0.97。WD-HCC与发育异常结节的比较显示，诊断WD-HCC的敏感性为50%，特异性为92%，sROC曲线下面积为0.80。