Liu Wenhong, Liu Jincai, Xiao Wenlian, Luo Guanghua
Radiology Department, The first Affiliated Hospital of University of South China, No. 69 Chuanshan Road, Shigu District, Hengyang, 421000 Hunan Province, China.
Radiology Department, The first Affiliated Hospital of University of South China, No. 69 Chuanshan Road, Shigu District, Hengyang, 421000 Hunan Province, China.
Acad Radiol. 2017 Oct;24(10):1216-1225. doi: 10.1016/j.acra.2017.04.013. Epub 2017 Jun 5.
This study aimed to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing small bowel (SB) Crohn disease (CD).
We systematically searched PubMed, Elsevier, ScienceDirect, Karger, Web of Science, Wiley Online Library, and Springer for studies in which CT or MRI were evaluated to assess SB CD. Bivariate random effect meta-analytic methods were used to estimate pooled sensitivity, specificity, and receiver operating characteristic curves. Diagnostic odds ratios (DORs) in a per-patient-based analysis were estimated. The area under the receiver operating characteristic curve was also calculated to measure the diagnostic accuracy.
Twenty-one studies involving 913 patients were included in this meta-analysis. There was no significant difference observed between modalities. The diagnostic performances (lnDOR) for CT and MRI also showed no significant difference. Subgroup analysis was performed for MR imaging (MR enteroclysis, MR enterography, and CT enterography). The diagnostic performances (lnDOR) for MR enteroclysis, MR enterography, and CT enterography did not show a significant difference among them. No significant difference was found between these techniques. Deeks funnel plot asymmetry test for publication bias showed that no significant publication bias was observed in this analysis.
This meta-analysis suggests that both MRI and CT have high diagnostic accuracy in detecting SB CD. MRI has the potential to be the first-line radiation-free modality for SB CD imaging.
本研究旨在评估磁共振成像（MRI）和计算机断层扫描（CT）在评估小肠克罗恩病（CD）方面的诊断准确性。
我们系统检索了PubMed、爱思唯尔、ScienceDirect、嘉格纳、科学网、威利在线图书馆和施普林格，以查找评估CT或MRI用于评估小肠克罗恩病的研究。采用双变量随机效应荟萃分析方法来估计合并敏感度、特异度和受试者操作特征曲线。在基于患者的分析中估计诊断比值比（DOR）。还计算了受试者操作特征曲线下面积以衡量诊断准确性。
本荟萃分析纳入了21项涉及913例患者的研究。不同检查方式之间未观察到显著差异。CT和MRI的诊断效能（lnDOR）也未显示出显著差异。对磁共振成像（磁共振小肠造影、磁共振小肠成像和CT小肠成像）进行了亚组分析。磁共振小肠造影、磁共振小肠成像和CT小肠成像的诊断效能（lnDOR）在它们之间未显示出显著差异。这些技术之间未发现显著差异。用于发表偏倚的Deeks漏斗图不对称性检验表明，本分析中未观察到显著的发表偏倚。
本荟萃分析表明，MRI和CT在检测小肠克罗恩病方面均具有较高的诊断准确性。MRI有可能成为小肠克罗恩病成像的一线无辐射检查方式。
