Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China.
Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA, USA.
Eur Radiol. 2019 Oct;29(10):5180-5189. doi: 10.1007/s00330-019-06071-5. Epub 2019 Mar 15.
The aim of this meta-analysis was to evaluate the diagnostic accuracy of hepatic magnetic resonance imaging-proton density fat fraction (MRI-PDFF) for the assessment of liver steatosis (LS) with histology as reference standard.
A systematic literature search was performed to identify pertinent studies. Quality analyses were conducted by Quality Assessment of Diagnostic Accuracy Studies-2. Diagnostic data were extracted and inconsistency index was calculated for LS≥G1, LS≥G2, and LS=G3, respectively. The area under summary receiver operating characteristic curve (AUC) served as the indicator of diagnostic accuracy. The pooled sensitivity and specificity were calculated if threshold effect was absent.
Thirteen studies containing 1100 subjects were included. There was significant threshold effect for LS≥G1. The AUCs for LS≥G1, LS≥G2, and LS=G3 were 0.98 (95% confidence interval (CI) 0.76, 1.00), 0.91 (95% CI 0.89, 0.94), and 0.92 (95% CI 0.89, 0.94), respectively. The pooled sensitivities for LS≥G2 and LS=G3 were 0.83 (95% CI 0.75, 0.88) and 0.79 (95% CI 0.63, 0.90), respectively; the pooled specificities for LS≥G2 and LS=G3 were 0.89 (95% CI 0.84, 0.92) and 0.89 (95% CI 0.84, 0.92), respectively.
MRI-PDFF has high diagnostic accuracy at detecting and grading LS with histology as reference standard, suggesting that MRI-PDFF is able to provide an accurate quantification of LS in clinical trials and patient care.
• MRI-PDFF is able to provide an accurate quantification of LS in clinical trials and patient care.
本荟萃分析旨在评估磁共振成像质子密度脂肪分数（MRI-PDFF）评估肝脂肪变性（LS）的诊断准确性，以组织学为参考标准。
进行了系统的文献检索以确定相关研究。通过质量评估诊断准确性研究-2 进行质量分析。分别提取 LS≥G1、LS≥G2 和 LS=G3 的诊断数据，并计算不一致指数。汇总受试者工作特征曲线下面积（AUC）作为诊断准确性的指标。如果不存在阈值效应，则计算合并的敏感度和特异度。
纳入了 13 项包含 1100 名受试者的研究。LS≥G1 存在显著的阈值效应。LS≥G1、LS≥G2 和 LS=G3 的 AUC 分别为 0.98（95%置信区间（CI）0.76，1.00）、0.91（95% CI 0.89，0.94）和 0.92（95% CI 0.89，0.94）。LS≥G2 和 LS=G3 的合并敏感度分别为 0.83（95% CI 0.75，0.88）和 0.79（95% CI 0.63，0.90）；LS≥G2 和 LS=G3 的合并特异度分别为 0.89（95% CI 0.84，0.92）和 0.89（95% CI 0.84，0.92）。
以组织学为参考标准，MRI-PDFF 检测和分级 LS 的诊断准确性高，提示 MRI-PDFF 能够在临床试验和患者护理中准确量化 LS。
MRI-PDFF 能够在临床试验和患者护理中准确量化 LS。
