Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea.
Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea.
Eur Radiol. 2021 Mar;31(3):1268-1280. doi: 10.1007/s00330-020-07240-7. Epub 2020 Sep 4.
To determine the diagnostic performance of neuromelanin-sensitive magnetic resonance imaging discriminating between patients with Parkinson's disease and normal healthy controls and to identify factors causing heterogeneity influencing the diagnostic performance.
A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before February 17, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Subgroup and meta-regression analyses were also performed to determine factors influencing heterogeneity.
Twelve articles including 403 patients with Parkinson's disease and 298 control participants were included in this systematic review and meta-analysis. Neuromelanin-sensitive magnetic resonance imaging showed a pooled sensitivity of 89% (95% confidence interval, 86-92%) and a pooled specificity of 83% (95% confidence interval, 76-88%). In the subgroup and meta-regression analysis, a disease duration longer than 5 and 10 years, comparisons using measured volumes instead of signal intensities, a slice thickness in terms of magnetic resonance imaging parameters of more than 2 mm, and semi-/automated segmentation methods instead of manual segmentation improved the diagnostic performance.
Neuromelanin-sensitive magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from healthy controls. To improve diagnostic accuracy, further investigations directly comparing these heterogeneity-affecting factors and optimizing these parameters are necessary.
• Neuromelanin-sensitive MRI favorably discriminates patients with Parkinson's disease from healthy controls. • Disease duration, parameters used for comparison, magnetic resonance imaging slice thickness, and segmentation methods affected heterogeneity across the studies.
确定神经黑色素敏感磁共振成像在区分帕金森病患者和健康对照组方面的诊断性能，并确定导致影响诊断性能的异质性的因素。
在 2020 年 2 月 17 日之前，对 Ovid-MEDLINE 和 EMBASE 数据库进行了系统的文献检索，以查找报告相关主题的研究。使用双变量随机效应模型计算汇总的敏感性和特异性值及其 95%置信区间。还进行了亚组和荟萃回归分析，以确定影响异质性的因素。
本系统评价和荟萃分析共纳入了 12 篇文章，包括 403 例帕金森病患者和 298 名对照参与者。神经黑色素敏感磁共振成像显示出 89%的汇总敏感性（95%置信区间，86-92%）和 83%的汇总特异性（95%置信区间，76-88%）。在亚组和荟萃回归分析中，疾病持续时间超过 5 年和 10 年、使用测量体积而不是信号强度进行比较、磁共振成像参数中的切片厚度超过 2 毫米、以及半自动/自动分割方法而不是手动分割均提高了诊断性能。
神经黑色素敏感磁共振成像在区分帕金森病患者与健康对照组方面具有良好的诊断性能。为了提高诊断准确性，需要进一步研究直接比较这些影响异质性的因素并优化这些参数。
• 神经黑色素敏感 MRI 有利于区分帕金森病患者与健康对照组。• 疾病持续时间、用于比较的参数、磁共振成像切片厚度和分割方法影响了研究之间的异质性。
