Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.
Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore.
J Magn Reson Imaging. 2022 Aug;56(2):490-507. doi: 10.1002/jmri.28037. Epub 2021 Dec 29.
Automated magnetic resonance imaging (MRI) volumetry is a promising tool to evaluate regional brain volumes in dementia and especially Alzheimer's disease (AD).
To compare automated methods and the gold standard manual segmentation in measuring regional brain volumes on MRI across healthy controls, patients with mild cognitive impairment, and patients with dementia due to AD.
Systematic review and meta-analysis.
MEDLINE, Embase, and PsycINFO were searched through October 2021.
1.0 T, 1.5 T, or 3.0 T.
Two review authors independently identified studies for inclusion and extracted data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).
Standardized mean differences (SMD; Hedges' g) were pooled using random-effects meta-analysis with robust variance estimation. Subgroup analyses were undertaken to explore potential sources of heterogeneity. Sensitivity analyses were conducted to examine the impact of the within-study correlation between effect estimates on the meta-analysis results.
Seventeen studies provided sufficient data to evaluate the hippocampus, lateral ventricles, and parahippocampal gyrus. The pooled SMD for the hippocampus, lateral ventricles, and parahippocampal gyrus were 0.22 (95% CI -0.50 to 0.93), 0.12 (95% CI -0.13 to 0.37), and -0.48 (95% CI -1.37 to 0.41), respectively. For the hippocampal data, subgroup analyses suggested that the pooled SMD was invariant across clinical diagnosis and field strength. Subgroup analyses could not be conducted on the lateral ventricles data and the parahippocampal gyrus data due to insufficient data. The results were robust to the selected within-study correlation value.
While automated methods are generally comparable to manual segmentation for measuring hippocampal, lateral ventricle, and parahippocampal gyrus volumes, wide 95% CIs and large heterogeneity suggest that there is substantial uncontrolled variance. Thus, automated methods may be used to measure these regions in patients with AD but should be used with caution.
3 TECHNICAL EFFICACY: Stage 3.
自动化磁共振成像（MRI）容积测量是评估痴呆症，特别是阿尔茨海默病（AD）患者脑区容积的一种很有前景的工具。
比较自动化方法和金标准手动分割在评估健康对照组、轻度认知障碍患者和 AD 所致痴呆患者的 MRI 脑区容积方面的应用。
系统综述和荟萃分析。
通过 2021 年 10 月检索 MEDLINE、Embase 和 PsycINFO。
1.0 T、1.5 T 或 3.0 T。
两位综述作者独立识别纳入的研究并提取数据。使用诊断准确性研究的质量评估 2 （QUADAS-2）工具评估方法学质量。
使用随机效应荟萃分析，采用稳健方差估计对标准化均数差值（SMD；Hedges' g）进行合并。进行亚组分析以探索潜在的异质性来源。进行敏感性分析以检验研究内效应估计值相关性对荟萃分析结果的影响。
17 项研究提供了足够的数据来评估海马体、侧脑室和海马旁回。海马体、侧脑室和海马旁回的合并 SMD 分别为 0.22（95% CI -0.50 至 0.93）、0.12（95% CI -0.13 至 0.37）和 -0.48（95% CI -1.37 至 0.41）。对于海马体数据，亚组分析表明，在不同的临床诊断和磁场强度下，合并 SMD 无差异。由于数据不足，无法对侧脑室数据和海马旁回数据进行亚组分析。选择的研究内相关性值对结果稳健。
尽管自动化方法通常可与手动分割相媲美，用于测量海马体、侧脑室和海马旁回的容积，但宽的 95% CI 和较大的异质性表明存在大量不可控的变异性。因此，在 AD 患者中可以使用自动化方法测量这些区域，但应谨慎使用。
3 级技术功效：3 级。
