钆塞酸二钠增强磁共振成像用于肝细胞癌的特征描述：一项系统评价和荟萃分析。
Gadoxetic acid-enhanced MRI for the characterization of hepatocellular carcinoma: A systematic review and meta-analysis.
作者信息
Duncan Joanna K, Ma Ning, Vreugdenburg Thomas D, Cameron Alun L, Maddern Guy
机构信息
Australian Safety and Efficacy Register of New Interventional Procedures, Surgical (ASERNIP-S), Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
Discipline of Surgery, University of Adelaide and the Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
出版信息
J Magn Reson Imaging. 2017 Jan;45(1):281-290. doi: 10.1002/jmri.25345. Epub 2016 Jun 14.
PURPOSE
To establish the relative diagnostic accuracy of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI) compared with contrast-enhanced computed tomography (CE-CT), dynamic MRI (D-MRI), gadopentetic acid-enhanced MRI (GP-MRI), or gadobenic acid-enhanced MRI (GB-MRI) in the characterization of hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
PubMed, EMBASE, the Cochrane Library, and the University of York CRD databases were searched to February 29 2016 for any studies that compared the diagnostic accuracy of GA-MRI to CE-CT, D-MRI, GP-MRI, or GB-MRI in patients with known or suspected HCC. Diagnostic accuracy outcomes (true positive, true negative, false positive, false negative) were extracted and analyzed using the bivariate model of Reitsma et al (2005).
RESULTS
In studies comparing GA-MRI to CE-CT in patients with any-sized lesions, estimated sensitivities were 0.881 (95% confidence interval [CI] = 0.766, 0.944) and 0.713 (95% CI = 0.577, 0.819) respectively. Estimated specificities were 0.926 (95% CI = 0.829, 0.97) and 0.918 (95% CI = 0.829, 0.963), respectively. This difference was not statistically significant. In studies including patients with small lesions GA-MRI was superior to CE-CT, with estimated sensitivities of 0.919 (95% CI = 0.834, 0.962) and 0.637 (95% CI = 0.565, 0.704 and estimated specificities of 0.936 (95% CI = 0.882, 0.966) and 0.971 (95% CI = 0.937, 0.987), respectively. In studies comparing GA-MRI to D-MRI in patients with any-sized lesions estimated sensitivities were 0.907 (95% CI = 0.870, 0.934) and 0.820 (95% CI = 0.776, 0.857); estimated specificities were 0.929 (95% CI = 0.877, 0.961) and 0.934 (95% CI = 0.881, 0.964).
CONCLUSION
GA-MRI has superior diagnostic ability to CE-CT in patients with small lesions. In patients with any-sized lesions there is no evidence that GA-MRI is superior to either CE-CT to D-MRI.
LEVEL OF EVIDENCE
3 J. Magn. Reson. Imaging 2017;45:281-290.
目的
比较钆塞酸二钠增强磁共振成像（GA-MRI）与对比增强计算机断层扫描（CE-CT）、动态MRI（D-MRI）、钆喷酸葡胺增强MRI（GP-MRI）或钆贝葡胺增强MRI（GB-MRI）在肝细胞癌（HCC）特征性诊断方面的相对准确性。
材料与方法
检索截至2016年2月29日的PubMed、EMBASE、Cochrane图书馆和约克大学CRD数据库，查找比较GA-MRI与CE-CT、D-MRI、GP-MRI或GB-MRI对已知或疑似HCC患者诊断准确性的任何研究。使用Reitsma等人（2005年）的双变量模型提取并分析诊断准确性结果（真阳性、真阴性、假阳性、假阴性）。
结果
在比较GA-MRI与CE-CT对任何大小病变患者的研究中，估计敏感性分别为0.881（95%置信区间[CI]=0.766，0.944）和0.713（95%CI=0.577，0.819）。估计特异性分别为0.926（95%CI=0.829，0.97）和0.918（95%CI=0.829，0.963）。这种差异无统计学意义。在纳入小病变患者的研究中，GA-MRI优于CE-CT，估计敏感性分别为0.919（95%CI=0.834，0.962）和0.637（95%CI=0.565，0.704），估计特异性分别为0.936（95%CI=0.882，0.966）和0.971（95%CI=0.937，0.987）。在比较GA-MRI与D-MRI对任何大小病变患者的研究中，估计敏感性分别为0.907（95%CI=0.870，0.934）和0.820（95%CI=0.776，0.857）；估计特异性分别为0.929（95%CI=0.877，0.961）和0.934（95%CI=0.881，0.964）。
结论
对于小病变患者，GA-MRI的诊断能力优于CE-CT。对于任何大小病变的患者，没有证据表明GA-MRI优于CE-CT或D-MRI。
证据级别
3 J.Magn.Reson.Imaging 2017；45：281-290。
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