Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Pharmacology, PGIMER, Chandigarh, India.
Br J Radiol. 2020 May 1;93(1109):20190847. doi: 10.1259/bjr.20190847. Epub 2020 Mar 18.
To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS).
We performed a literature search in PubMed, Embase, and Scopus to identify articles reporting the diagnostic accuracy of Doppler ultrasound, CT, and MRI (either alone or in combination) for BCS using catheter venography or surgery as the reference standard. The quality of the included articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
11 studies were found eligible for inclusion. Pooled sensitivities and specificities of Doppler ultrasound were 89% [95% confidence interval (CI), 81-94%, I = 24.7%] and 68% (95% CI, 3-99%, I = 95.2%), respectively. Regarding CT, the pooled sensitivities and specificities were 89% (95% CI, 77-95%, I = 78.6%) and 72% (95% CI, 21-96%, I = 91.4%), respectively. The pooled sensitivities and specificities of MRI were 93% (95% CI, 89-96%, I = 10.6%) and 55% (95% CI, 5-96%, I = 87.6%), respectively. The pooled DOR for Doppler ultrasound, CT, and MRI were 10.19 (95% CI: 1.5, 69.2), 14.57 (95% CI: 1.13, 187.37), and 20.42 (95% CI: 1.78, 234.65), respectively. The higher DOR of MRI than that of Doppler ultrasound and CT shows the better discriminatory power. The area under the curve for MRI was 90.8% compared with 88.4% for CT and 86.6% for Doppler ultrasound.
Doppler ultrasound, CT and MRI had high overall diagnostic accuracy for diagnosis of BCS, but substantial heterogeneity was found. Prospective studies are needed to investigate diagnostic performance of these imaging modalities.
MRI and CT have the highest meta-analytic sensitivity and specificity, respectively for the diagnosis of BCS. Also, MRI has the highest area under curve for the diagnosis of BCS.
评估多普勒超声、CT 和 MRI 在诊断布加综合征（BCS）中的灵敏度、特异度和诊断比值比（DOR）。
我们在 PubMed、Embase 和 Scopus 中进行了文献检索，以确定使用导管静脉造影或手术作为参考标准报告多普勒超声、CT 和 MRI（单独或联合使用）诊断 BCS 的准确性的文章。使用诊断准确性研究质量评估工具 2 对纳入的文章进行质量评估。
发现 11 项研究符合纳入标准。多普勒超声的汇总灵敏度和特异度分别为 89%（95%置信区间，81-94%，I = 24.7%）和 68%（95%置信区间，3-99%，I = 95.2%）。对于 CT，汇总的灵敏度和特异度分别为 89%（95%置信区间，77-95%，I = 78.6%）和 72%（95%置信区间，21-96%，I = 91.4%）。MRI 的汇总灵敏度和特异度分别为 93%（95%置信区间，89-96%，I = 10.6%）和 55%（95%置信区间，5-96%，I = 87.6%）。多普勒超声、CT 和 MRI 的汇总 DOR 分别为 10.19（95%CI：1.5，69.2）、14.57（95%CI：1.13，187.37）和 20.42（95%CI：1.78，234.65）。MRI 的 DOR 高于多普勒超声和 CT，表明其具有更好的鉴别能力。MRI 的曲线下面积为 90.8%，而 CT 为 88.4%，多普勒超声为 86.6%。
多普勒超声、CT 和 MRI 对 BCS 的诊断具有较高的总体诊断准确性，但存在较大的异质性。需要前瞻性研究来评估这些成像方式的诊断性能。
MRI 和 CT 分别具有诊断 BCS 的最高 meta 分析灵敏度和特异度。此外，MRI 对 BCS 的诊断具有最高的曲线下面积。
