Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
Sci Rep. 2020 Feb 6;10(1):1969. doi: 10.1038/s41598-020-58855-1.
The prognosis of colorectal cancer (CRC) is largely dependent on the early detection of hepatic metastases. With the advantages of nonradioactivity and the availability of multiple scanning sequences, the efficacy of magnetic resonance imaging (MRI) in the detection of colorectal liver metastases (CRLM) is not yet clear. We performed this meta-analysis to address this issue. PubMed, Embase, and the Cochrane Library were searched for studies reporting diagnostic performance of MRI for CRLM. Descriptive and quantitative data were extracted. The study quality was evaluated for the identified studies and a random effects model was used to determine the integrated diagnosis estimation. Meta-regression and subgroup analyses were implemented to investigate the potential contributors to heterogeneity. As a result, seventeen studies were included for analysis (from the year 1996 to 2018), comprising 1121 patients with a total of 3279 liver lesions. The pooled sensitivity, specificity, and diagnostic odds ratio were 0.90 (95% confidence intervals (CI): 0.81-0.95), 0.88 (0.80-0.92), and 62.19 (23.71-163.13), respectively. The overall weighted area under the curve was 0.94 (0.92-0.96). Using two or more imaging planes and a quantitative/semiquantitative interpretation method showed higher diagnostic performance, although only the latter demonstrated statistical significance (P < 0.05). Advanced scanning sequences with DWI and liver-specific contrast media tended to increase the sensitivity for CRLM detection. We therefore concluded that contemporary MRI has high sensitivity and specificity for screening CRLM, especially for those with advanced scanning sequences. Using two or more imaging planes and adopting a quantitative/semiquantitative imaging interpretation may further improve diagnosis. However, the MRI results should be interpreted with caution because of substantial heterogeneity among studies.
结直肠癌（CRC）的预后在很大程度上取决于肝转移的早期发现。磁共振成像（MRI）具有非放射性和多种扫描序列可用性的优势，但其在结直肠癌肝转移（CRLM）检测中的效能尚不清楚。我们进行了这项荟萃分析来解决这个问题。我们在 PubMed、Embase 和 Cochrane Library 中搜索了报告 MRI 对 CRLM 诊断性能的研究。提取描述性和定量数据。对确定的研究进行了研究质量评估，并使用随机效应模型确定了综合诊断估计。进行了荟萃回归和亚组分析，以研究异质性的潜在来源。结果，纳入了 17 项研究进行分析（1996 年至 2018 年），共纳入 1121 名患者，共计 3279 个肝脏病变。汇总敏感性、特异性和诊断优势比分别为 0.90（95%置信区间（CI）：0.81-0.95）、0.88（0.80-0.92）和 62.19（23.71-163.13）。总体加权曲线下面积为 0.94（0.92-0.96）。使用两个或更多成像平面和定量/半定量解释方法显示出更高的诊断性能，尽管只有后者具有统计学意义（P < 0.05）。具有 DWI 和肝脏特异性对比剂的先进扫描序列往往会提高 CRLM 的检测敏感性。因此，我们得出结论，现代 MRI 对 CRLM 的筛查具有较高的敏感性和特异性，特别是对于那些具有先进扫描序列的患者。使用两个或更多成像平面并采用定量/半定量成像解释可能会进一步提高诊断。然而，由于研究之间存在很大的异质性，MRI 结果的解释应谨慎。
