Wang Xiao-Min, Zhang Xiao-Jing, Ma Lin
Department of Radiology, Chinese PLA General Hospital, Beijing School of Medical Imaging, Tianjin Medical University, Tianjin, China.
Medicine (Baltimore). 2018 May;97(21):e10605. doi: 10.1097/MD.0000000000010605.
The aim of this study was to evaluate the diagnostic accuracy of magnetic resonance (MR) imaging-based methods for detecting steatosis and fibrosis in nonalcoholic fatty liver disease (NAFLD).
Data were extracted from research articles obtained after a literature search from multiple electronic databases. Random-effects meta-analyses were performed to obtain overall effect size of the area of operator receiver curve (AUROC), sensitivity and specificity of MR imaging, MR elastography, and MR spectroscopy in detecting or grading steatosis/fibrosis. Meta-analysis of correlation coefficients was performed to have an overall effect size of correlation between MR-based diagnosis and histological diagnosis.
Twenty-one studies (1658 subjects; 45.32 years [95% CI: 35.94, 54.71] of age, 53.67% [45.39, 61.95] males, and 29.98 kg/m [21.93, 38.04] BMI) were included in the meta-analysis. Pooled analyses of the AUROC, specificity, and sensitivity values reported in the individual studies revealed an overall effect sizes of 0.90 (0.88, 0.92), 82.27% (77.74, 86.80), and 86.94% (84.18, 95.28) in the use of any MR-based technique for the diagnosis of NAFLD or its severity. The correlation coefficient between MR-based detection of liver steatosis and histologically measured steatosis was 0.748 (0.706, 0.789) (P < .00001).
MRI-based diagnostic methods are valuable additions in detecting NAFLD or determining the severity of the NAFLD.
本研究旨在评估基于磁共振（MR）成像的方法在检测非酒精性脂肪性肝病（NAFLD）中的脂肪变性和纤维化的诊断准确性。
从多个电子数据库文献检索后获得的研究文章中提取数据。进行随机效应荟萃分析，以获得用于检测或分级脂肪变性/纤维化的磁共振成像、磁共振弹性成像和磁共振波谱的受试者工作特征曲线下面积（AUROC）、敏感性和特异性的总体效应大小。进行相关系数的荟萃分析，以获得基于磁共振的诊断与组织学诊断之间相关性的总体效应大小。
荟萃分析纳入了21项研究（1658名受试者；年龄45.32岁[95%可信区间：35.94，54.71]，男性占53.67%[45.39，61.95]，体重指数为29.98kg/m²[21.93，38.04]）。对各研究报告的AUROC、特异性和敏感性值进行汇总分析，结果显示，使用任何基于磁共振的技术诊断NAFLD或其严重程度时，总体效应大小分别为0.90（0.88，0.92）、82.27%（77.74，86.80）和86.94%（84.18，95.28）。基于磁共振检测的肝脏脂肪变性与组织学测量的脂肪变性之间的相关系数为0.748（0.706，0.789）（P<0.00001）。
基于磁共振成像的诊断方法在检测NAFLD或确定NAFLD的严重程度方面是有价值的补充。
