Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
Clin Radiol. 2020 Jul;75(7):562.e1-562.e10. doi: 10.1016/j.crad.2020.03.025. Epub 2020 Apr 14.
To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of metastatic cervical lymph nodes.
Ovid-MEDLINE and EMBASE databases were searched up until 12 June 2018. Eleven articles were included in the qualitative systematic review and nine of the 11 in the quantitative analysis. Two radiologists independently performed data extraction and methodological quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A qualitative systematic review and quantitative analysis were performed, followed by a meta-regression analysis to determine factors causing heterogeneity.
The pooled sensitivity and specificity in the diagnosis of metastatic cervical lymph nodes were 80% (95% confidence interval [CI]: 68-88%) and 85% (95% CI: 63-95%), respectively. The sensitivity and false-positive rate (correlation coefficient, 0.655) showed a positive correlation due to a threshold effect, which was responsible for heterogeneity across the studies, as indicated by a Q-test (p<0.01) and Higgins I statistic (sensitivity, I=90.11%; specificity, I=92.49%). In the meta-regression analysis, fat-suppressed imaging, and the analysis method were significant factors influencing the heterogeneity in diagnostic performance.
MRI shows moderate diagnostic performance in the diagnosis of metastatic lymph nodes in patients with thyroid cancer in the neck. MRI may be an optional or complementary imaging method to ultrasound or computed tomography (CT) in thyroid cancer patients.
评估磁共振成像（MRI）在诊断转移性颈淋巴结中的诊断性能。
检索了 Ovid-MEDLINE 和 EMBASE 数据库，截至 2018 年 6 月 12 日。11 篇文章纳入定性系统评价，其中 11 篇中的 9 篇纳入定量分析。两名放射科医生使用 QUADAS-2 工具独立进行数据提取和方法学质量评估。进行定性系统评价和定量分析，然后进行荟萃回归分析以确定导致异质性的因素。
诊断转移性颈淋巴结的汇总敏感性和特异性分别为 80%（95%置信区间：68-88%）和 85%（95%置信区间：63-95%）。由于阈值效应，敏感性和假阳性率（相关系数为 0.655）呈正相关，这是研究间异质性的原因，Q 检验（p<0.01）和 Higgins I 统计量（敏感性，I=90.11%；特异性，I=92.49%）均表明存在异质性。在荟萃回归分析中，脂肪抑制成像和分析方法是影响诊断性能异质性的重要因素。
MRI 在诊断颈部甲状腺癌患者的转移性淋巴结方面具有中等诊断性能。MRI 可能是甲状腺癌患者超声或计算机断层扫描（CT）的可选或补充成像方法。
