钆塞酸二钠增强磁共振成像多动脉期图像的临床应用价值：系统评价和荟萃分析。
Clinical usefulness of multiple arterial-phase images in gadoxetate disodium-enhanced magnetic resonance imaging: a systematic review and meta-analysis.
机构信息
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Radiology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea.
出版信息
Eur Radiol. 2022 Aug;32(8):5413-5423. doi: 10.1007/s00330-022-08620-x. Epub 2022 Feb 22.
OBJECTIVES
The multiple arterial-phase (AP) technique was introduced for liver MRI, but it is not really known if multiple AP MRI (MA-MRI) improves image quality and lesion detection rate on gadoxetate disodium-enhanced MRI in comparison with single AP MRI (SA-MRI). We aimed to determine the clinical usefulness of MA-MRI in comparison with SA-MRI.
METHODS
Original articles reporting the percentage of adequate AP imaging and the lesion detection rate on gadoxetate disodium-enhanced MA-MRI were identified in PubMed, EMBASE, and Cochrane Library databases. The pooled percentage of adequate AP imaging and lesion detection rate were calculated using random-effects meta-analysis of single proportions. Subgroup analysis was performed to explain causes of study heterogeneity, and publication bias was evaluated using Egger's test.
RESULTS
Of 772 articles screened, 22 studies in 12 articles were included: 18 studies (ten MA-MRI and eight SA-MRI) suitably defined the percentage of adequate AP imaging and four (three MA-MRI and one SA-MRI) defined the lesion detection rate. MA-MRI had 16.1% higher pooled percentage of adequate AP imaging than SA-MRI (94.8% vs. 78.7%, p < 0.01). MA-MRI additionally detected 33.2% of lesions than SA-MRI (83.2% vs. 50.0%, p = 0.06). Substantial study heterogeneity was found in MA-MRI, and the definition of adequate AP imaging, lesion characteristics, and reference standards were significant factors affecting study heterogeneity (p ≤ 0.02). Significant publication bias was found in MA-MRI (p < 0.01) but not in SA-MRI studies (p = 0.87).
CONCLUSIONS
Gadoxetate disodium-enhanced MA-MRI may be more clinically useful than SA-MRI, but further study is necessary to validate this finding because of study heterogeneity and publication bias.
KEY POINTS
• Multiple arterial-phase MRI (MA-MRI) had a 16.1% higher pooled percentage of adequate AP imaging than single arterial-phase MRI (SA-MRI) (94.8% vs. 78.7%, p < 0.01). • MA-MRI additionally detected an extra 33.2% of lesions compared with SA-MRI (83.2% vs. 50.0%, p = 0.06). • Substantial study heterogeneity and significant publication bias were found across MA-MRI studies.
目的
多期动脉相（AP）技术已被引入肝脏 MRI 中，但与单期动脉相（SA-MRI）相比，多期动脉相 MRI（MA-MRI）是否能提高钆塞酸二钠增强 MRI 的图像质量和病灶检出率，目前尚不清楚。我们旨在确定 MA-MRI 与 SA-MRI 相比的临床应用价值。
方法
在 PubMed、EMBASE 和 Cochrane 图书馆数据库中，确定了报告钆塞酸二钠增强 MA-MRI 中适当 AP 成像百分比和病灶检出率的原始文章。使用单比例随机效应荟萃分析计算适当 AP 成像百分比和病灶检出率的合并百分比。进行亚组分析以解释研究异质性的原因，并使用 Egger 检验评估发表偏倚。
结果
在筛选出的 772 篇文章中，有 22 项研究（12 篇文章中的 18 项 MA-MRI 和 8 项 SA-MRI）适当定义了适当 AP 成像的百分比，4 项（3 项 MA-MRI 和 1 项 SA-MRI）定义了病灶检出率。MA-MRI 的适当 AP 成像百分比比 SA-MRI 高 16.1%（94.8%比 78.7%，p<0.01）。MA-MRI 比 SA-MRI 多检出 33.2%的病灶（83.2%比 50.0%，p=0.06）。在 MA-MRI 中发现了大量的研究异质性，并且适当 AP 成像的定义、病灶特征和参考标准是影响研究异质性的重要因素（p≤0.02）。在 MA-MRI 中发现了显著的发表偏倚（p<0.01），但在 SA-MRI 研究中未发现（p=0.87）。
结论
与 SA-MRI 相比，钆塞酸二钠增强 MA-MRI 可能更具临床应用价值，但由于研究异质性和发表偏倚，仍需要进一步研究来验证这一发现。
关键点
MA-MRI 的适当 AP 成像百分比比 SA-MRI 高 16.1%（94.8%比 78.7%，p<0.01）。
MA-MRI 比 SA-MRI 多检出 33.2%的病灶（83.2%比 50.0%，p=0.06）。
在 MA-MRI 研究中发现了大量的研究异质性和显著的发表偏倚。
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