From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Invest Radiol. 2022 Jan 1;57(1):62-70. doi: 10.1097/RLI.0000000000000806.
The aims of this study were to determine the incidence of transient severe motion artifact (TSM) on arterial phase gadoxetic acid-enhanced magnetic resonance imaging of the liver and to investigate the causes of heterogeneity in the published literature.
Original studies reporting the incidence of TSM were identified in searches of PubMed, Embase, and Cochrane Library databases. The pooled incidence of TSM was calculated using random-effects meta-analysis of single proportions. Subgroup analyses were conducted to explore causes of heterogeneity.
A total of 24 studies were finally included (single arterial phase, 19 studies with 3065 subjects; multiple arterial phases, 8 studies with 2274 subjects). Studies using single arterial phase imaging reported individual TSM rates varying from 4.8% to 26.7% and a pooled incidence of TSM of 13.0% (95% confidence interval, 10.3%-16.2%), which showed substantial study heterogeneity. The pooled incidence of TSM in the studies using multiple arterial phase imaging was 3.2% (95% confidence interval, 1.9%-5.2%), which was significantly less than in those studies using single arterial phase imaging (P < 0.001). In the subgroup analysis, the geographical region of studies and the definition of TSM were found to be causes of heterogeneity. The incidence of TSM was higher in studies with Western populations from Europe or North America than in those with Eastern (Asia/Pacific) populations (16.0% vs 8.8%, P = 0.005). Regarding the definition of TSM, the incidence of TSM was higher when a 4-point scale was used for its categorization than when a 5-point scale was used (20.0% vs 11.0%, P = 0.008), and a definition considering motion artifact on phases other than arterial phase imaging lowered the incidence of TSM compared with it being defined only on arterial phase imaging (11.3% vs 20.3%, P = 0.018).
The incidence of TSM on arterial phase images varied across studies and was associated with the geographical region of studies and the definition of TSM. Careful interpretation of results reporting TSM might therefore be needed.
本研究旨在确定钆塞酸增强磁共振成像肝动脉期一过性严重运动伪影（TSM）的发生率，并探讨文献报道中异质性的原因。
在 PubMed、Embase 和 Cochrane Library 数据库中检索报告 TSM 发生率的原始研究。采用单比例随机效应荟萃分析计算 TSM 的总发生率。进行亚组分析以探讨异质性的原因。
最终纳入 24 项研究（单动脉期 19 项研究共 3065 例；多动脉期 8 项研究共 2274 例）。采用单动脉期成像的研究报告的个体 TSM 发生率从 4.8%到 26.7%不等，TSM 的总发生率为 13.0%（95%置信区间：10.3%-16.2%），存在显著的研究异质性。采用多动脉期成像的研究中 TSM 的总发生率为 3.2%（95%置信区间：1.9%-5.2%），明显低于采用单动脉期成像的研究（P < 0.001）。在亚组分析中，研究的地理位置和 TSM 的定义被发现是异质性的原因。来自欧洲或北美的西方人群研究中 TSM 的发生率高于亚洲/太平洋地区的人群（16.0%比 8.8%，P = 0.005）。关于 TSM 的定义，当使用 4 分制对其进行分类时，TSM 的发生率高于使用 5 分制（20.0%比 11.0%，P = 0.008），并且将运动伪影定义为不仅限于动脉期成像时，TSM 的发生率较低（11.3%比 20.3%，P = 0.018）。
动脉期图像上 TSM 的发生率在不同的研究中有所不同，与研究的地理位置和 TSM 的定义有关。因此，对报告 TSM 的研究结果进行仔细解读可能是必要的。
