Lu Liping, Pan Xuming
Liping Lu, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou, Zhejiang Province, China.
Xuming Pan, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, Zhejiang Province, China.
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):743-750. doi: 10.12669/pjms.38.3.5142.
Non-contrast MRI is used for identifying patients with hepatocellular carcinoma (HCC), especially among high-risk patients with cirrhosis or chronic viral hepatitis. The accuracy of non-contrast MRI has been investigated with varying results. We performed this meta-analysis to consolidate the evidence on the accuracy of non-contrast MRI for the detection of HCC. We conducted a systematic search in the databases of PubMed Central, SCOPUS, MEDLINE, EMBASE and Cochrane from inception till November 2020. We used the STATA software "Midas" package for meta-analysis. We included 15 studies with 3,756 patients. The pooled sensitivity and specificity of non-contrast MRI for HCC detection were 84% (95%CI, 78%-88%) and 94% (95%CI, 91%-97%). The positive likelihood ratio was 14.9 (95% CI, 9.0-24.7) and the negative one 0.17 (0.12-0.23). The overall quality of the studies was high. We found significant heterogeneity based on chi-square test results and I statistic > 75%. Deek's test showed the absence of publication bias. We found that non-contrast MRI has high sensitivity and specificity as a tool for detecting HCC. Studies exploring its accuracy in different ethnic populations are required to strengthen the evidence.
非增强磁共振成像（MRI）用于识别肝细胞癌（HCC）患者，尤其是在患有肝硬化或慢性病毒性肝炎的高危患者中。非增强MRI的准确性已得到研究，但结果各异。我们进行了这项荟萃分析，以巩固关于非增强MRI检测HCC准确性的证据。我们对截至2020年11月的PubMed Central、SCOPUS、MEDLINE、EMBASE和Cochrane数据库进行了系统检索。我们使用STATA软件的“Midas”包进行荟萃分析。我们纳入了15项研究，共3756名患者。非增强MRI检测HCC的合并敏感性和特异性分别为84%（95%CI，78%-88%）和94%（95%CI，91%-97%）。阳性似然比为14.9（95%CI，9.0-24.7），阴性似然比为0.17（0.12-0.23）。研究的整体质量较高。基于卡方检验结果和I统计量>75%，我们发现存在显著异质性。Deek检验显示不存在发表偏倚。我们发现非增强MRI作为检测HCC的工具具有较高的敏感性和特异性。需要开展在不同种族人群中探索其准确性的研究以加强证据。
