Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing 100050, China.
Department of Radiology, Beijing Changping Hospital, Beijing 102200, China.
Eur J Radiol. 2020 Apr;125:108857. doi: 10.1016/j.ejrad.2020.108857. Epub 2020 Jan 30.
To evaluate the diagnostic efficacy of gadoxetic acid-enhanced MRI for the staging of liver fibrosis by meta-analysis.
PubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched. Studies were included according to their eligibility and the exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality. The bivariate random-effects model was used to obtain the pooled summary estimates, heterogeneity, and the area under summary receiver operating characteristic curves (AUROC). Meta-regression was performed to discover the source of heterogeneity and compare certain some subsets for their capacity to stage hepatic fibrosis by AUROC comparison.
A total of 20 original articles (1936 patients) were included. Most studies had a low risk of bias and minimal concerns regarding applicability. The summary AUROC values of gadoxetic acid-enhanced MRI in staging the liver fibrosis ≥ F1, ≥ F2, ≥ F3, and F4 subsets were 0.92, 0.87, 0.89, and 0.91, respectively. Studies with populations equal to or more than 100 had a significantly higher sensitivity (84 %) and specificity (91 %) than those with populations less than 100 (70 % and 77 %, respectively, P < 0.01). Studies of a prospective design exhibited a significantly higher sensitivity (94 %) and specificity (94 %) than those of a retrospective design (75 % and 84 %, respectively, P < 0.01).
Our meta-analysis shows the high diagnostic efficacy of gadoxetic acid-enhanced MRI in the staging of liver fibrosis. A prospective study with more than one hundred patients showed higher diagnostic efficacy.
通过荟萃分析评估钆塞酸增强 MRI 对肝纤维化分期的诊断效能。
检索 PubMed/Medline、EMBASE、Web of Science 和 Cochrane Library。根据纳入和排除标准筛选研究。使用诊断准确性研究质量评估工具 2 版（QUADAS-2）评估方法学质量。采用双变量随机效应模型获取汇总的似然比、异质性和汇总受试者工作特征曲线下面积（AUROC）。进行 Meta 回归以发现异质性的来源，并通过 AUROC 比较比较某些亚组对肝纤维化分期的能力。
共纳入 20 项原始研究（1936 例患者）。大多数研究的偏倚风险较低，应用问题的担忧较小。钆塞酸增强 MRI 对肝纤维化 F1、F2、F3 和 F4 分期的汇总 AUROC 值分别为 0.92、0.87、0.89 和 0.91。患者人数等于或多于 100 例的研究的敏感性（84%）和特异性（91%）显著高于患者人数少于 100 例的研究（分别为 70%和 77%，P<0.01）。前瞻性设计的研究的敏感性（94%）和特异性（94%）显著高于回顾性设计的研究（分别为 75%和 84%，P<0.01）。
我们的荟萃分析表明，钆塞酸增强 MRI 对肝纤维化分期具有较高的诊断效能。具有 100 例以上患者的前瞻性研究显示出更高的诊断效能。
