Virarkar Mayur, Diab Radwan, Palmquist Sarah, Bassett Roland, Bhosale Priya
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, US.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, US.
J Belg Soc Radiol. 2020 Nov 24;104(1):69. doi: 10.5334/jbsr.2275.
To perform a meta-analysis comparing the diagnostic performance of increased signal intensity on T1- and T2-weighted magnetic resonance images and apparent diffusion coefficient (ADC) values in differentiating uterine leiomyosarcoma (LMS) from benign leiomyoma (LM).
A systematic literature search for original studies was performed using PubMed/MEDLINE, the Cochrane Library, Embase, and Web of Science. Data necessary for the meta-analysis was extracted from the selected articles and analyzed.
Eight studies with 795 patients met our predefined inclusion criteria and were included in the analysis. Increased signal on T1-weighted imaging had a pooled sensitivity of 56.8% (95% CI: 20%-87.4%) for LMS (n = 60) which was significantly higher than 7.6% (95% CI: 2.2%-22.7%) for LM (n = 1272) ( = 0.0094). Increased signal analysis on T2-weighted imaging had a pooled sensitivities of 93.2% and 93.2% (95% CI: 45.7%-99.6% and 42.9%-99.6%) for LMS (n = 90), which were not significantly different from the 54.5% and 53.9% (95% CI: 33.6%-74%, 32%-74%) for LM (n = 215) ( = 0.102 and 0.112). On ADC value analysis, LMS (n = 43) had a weighted mean and standard deviation of 0.896 ± 0.19 10 mm/s, 0.929 ± 0.182 10 mm/s, which were significantly lower from 1.258 ± 0.303 10 mm/s, 1.304 ± 0.303 10 mm/s for LM (n = 159) ( = < 0.0001, < 0.0001).
Our meta-analysis demonstrated that high signal intensity on T1-weighted images and low ADC values can accurately differentiate LMS from LM. Although, LMS had a higher pooled sensitivity for T2-weighted increased signal intensity compared to LM, there was no statistical significance.
进行一项荟萃分析，比较T1加权和T2加权磁共振图像上信号强度增加以及表观扩散系数（ADC）值在鉴别子宫平滑肌肉瘤（LMS）与良性平滑肌瘤（LM）中的诊断性能。
使用PubMed/MEDLINE、Cochrane图书馆、Embase和Web of Science对原始研究进行系统文献检索。从选定的文章中提取荟萃分析所需的数据并进行分析。
八项研究共795例患者符合我们预先设定的纳入标准并纳入分析。T1加权成像上信号增加对LMS（n = 60）的合并敏感度为56.8%（95%CI：20%-87.4%），显著高于对LM（n = 1272）的7.6%（95%CI：2.2%-22.7%）（P = 0.0094）。T2加权成像上信号增加分析对LMS（n = 90）的合并敏感度分别为93.2%和93.2%（95%CI：45.7%-99.6%和42.9%-99.6%），与对LM（n = 215）的54.5%和53.9%（95%CI：33.6%-74%，32%-74%）无显著差异（P = 0.102和0.112）。在ADC值分析中，LMS（n = 43）的加权平均值和标准差分别为0.896±0.19×10⁻³mm²/s、0.929±0.182×10⁻³mm²/s，显著低于LM（n = 159）的1.258±0.303×10⁻³mm²/s、1.304±0.303×10⁻³mm²/s（P = <0.0001，<0.0001）。
我们的荟萃分析表明，T1加权图像上的高信号强度和低ADC值可准确鉴别LMS与LM。虽然LMS对T2加权信号强度增加的合并敏感度高于LM，但无统计学意义。
