From the Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China (L.H.); and Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Rd, Guangzhou 510630, China (Q.K., Z.L., J.W., Z.K., Y.Z.).
Radiology. 2018 Feb;286(2):502-511. doi: 10.1148/radiol.2017171028. Epub 2017 Dec 4.
Purpose To assess the diagnostic accuracy of magnetic resonance (MR) imaging for differentiating stage T1 or lower tumors from stage T2 or higher tumors and to analyze the influence of different imaging protocols in patients with bladder cancer. Materials and Methods A systematic literature search for original diagnostic studies was performed in PubMed, Medline, the Cochrane Library, and Web of Science. The methodologic quality of each study was evaluated by two independent reviewers who used the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data necessary to complete 2 × 2 tables were obtained, and patient, study, and imaging characteristics were extracted. Statistical analysis included data pooling, heterogeneity testing, sensitivity analyses, and forest plot construction. Results Seventeen studies (1449 patients with bladder cancer) could be analyzed. The pooled sensitivity and specificity of MR imaging were 0.90 (95% confidence interval [CI]: 0.83, 0.94) and 0.88 (95% CI: 0.77, 0.94), respectively, for differentiating tumors staged T1 or lower from those staged T2 or higher. Diffusion-weighted imaging and use of higher field strengths (3 T) improved sensitivity (0.92; 95% CI: 0.86, 0.96) and specificity (0.96; 95% CI: 0.93, 0.98). Conclusion This meta-analysis demonstrated high diagnostic performance of MR imaging for differentiating T1 or lower tumors from T2 or higher tumors in patients with bladder cancer. Higher field strength (3 T) and the use of diffusion-weighted imaging can slightly help improve sensitivity and specificity. RSNA, 2017.
评估磁共振成像（MR 成像）在区分 T1 期或更低期肿瘤与 T2 期或更高期肿瘤方面的诊断准确性，并分析不同成像方案对膀胱癌患者的影响。
在 PubMed、Medline、Cochrane 图书馆和 Web of Science 中进行了系统的文献检索，以获取原始诊断研究。两位独立的审查员使用 QUADAS-2 工具评估了每项研究的方法学质量。获取了完成 2×2 表格所需的数据，并提取了患者、研究和影像学特征。统计分析包括数据汇总、异质性检验、敏感性分析和森林图构建。
17 项研究（1449 例膀胱癌患者）可进行分析。MR 成像区分 T1 期或更低期肿瘤与 T2 期或更高期肿瘤的汇总敏感性和特异性分别为 0.90（95%置信区间：0.83，0.94）和 0.88（95%置信区间：0.77，0.94）。扩散加权成像和使用更高场强（3 T）可提高敏感性（0.92；95%置信区间：0.86，0.96）和特异性（0.96；95%置信区间：0.93，0.98）。
本荟萃分析表明，MR 成像在区分膀胱癌患者 T1 期或更低期肿瘤与 T2 期或更高期肿瘤方面具有较高的诊断性能。更高场强（3 T）和使用扩散加权成像技术可能略微有助于提高敏感性和特异性。RSNA，2017 年。
