磁共振成像（MRI）评估急性阑尾炎诊断性能的系统评价与Meta分析

A Systematic Review and Meta-Analysis of Diagnostic Performance of MRI for Evaluation of Acute Appendicitis.

作者信息

Duke Eugene, Kalb Bobby, Arif-Tiwari Hina, Daye Zhongyin John, Gilbertson-Dahdal Dorothy, Keim Samuel M, Martin Diego R

机构信息

1 Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave, PO Box 245067, Rm 1345, Tucson, AZ 85724.

2 Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, Tucson, AZ.

出版信息

AJR Am J Roentgenol. 2016 Mar;206(3):508-17. doi: 10.2214/AJR.15.14544.

DOI:10.2214/AJR.15.14544

PMID:26901006

Abstract

OBJECTIVE

A meta-analysis was performed to determine the accuracy of MRI in the diagnosis of acute appendicitis in the general population and in subsets of pregnant patients and children.

MATERIALS AND METHODS

A systematic search of the PubMed and EMBASE databases for articles published through the end of October 2014 was performed to identify studies that used MRI to evaluate patients suspected of having acute appendicitis. Pooled data for sensitivity, specificity, and positive and negative predictive values were calculated.

RESULTS

A total of 30 studies that comprised 2665 patients were reviewed. The sensitivity and specificity of MRI for the diagnosis of acute appendicitis are 96% (95% CI, 95-97%) and 96% (95% CI, 95-97%), respectively. In a subgroup of studies that focused solely on pregnant patients, the sensitivity and specificity of MRI were 94% (95% CI, 87-98%) and 97% (95% CI, 96-98%), respectively, whereas in studies that focused on children, sensitivity and specificity were found to be 96% (95% CI, 95-97%) and 96% (95% CI, 94-98%), respectively.

CONCLUSION

MRI has a high accuracy for the diagnosis of acute appendicitis, for a wide range of patients, and may be acceptable for use as a first-line diagnostic test.

摘要

目的

进行一项荟萃分析，以确定MRI在普通人群、孕妇亚组和儿童亚组中诊断急性阑尾炎的准确性。

材料与方法

对PubMed和EMBASE数据库进行系统检索，查找截至2014年10月底发表的使用MRI评估疑似急性阑尾炎患者的研究。计算敏感性、特异性以及阳性和阴性预测值的合并数据。

结果

共纳入30项研究，涉及2665例患者。MRI诊断急性阑尾炎的敏感性和特异性分别为96%（95%CI，95 - 97%）和96%（95%CI，95 - 97%）。在仅关注孕妇的亚组研究中，MRI的敏感性和特异性分别为94%（95%CI，87 - 98%）和97%（95%CI，96 - 98%），而在关注儿童的研究中，敏感性和特异性分别为96%（95%CI，95 - 97%）和96%（95%CI，94 - 98%）。