磁共振成像与计算机断层扫描在急性胰腺炎诊断中的比较：诊断试验准确性研究的系统评价和荟萃分析
Comparison of magnetic resonance imaging and computed tomography in the diagnosis of acute pancreatitis: a systematic review and meta-analysis of diagnostic test accuracy studies.
作者信息
Sun Hui, Jian Sha, Peng Bo, Hou Jian
机构信息
Clinical Medicine, Chengdu University of Traditional Chinese Medicine Shierqiao Campus, Chengdu, China.
Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Ann Transl Med. 2022 Apr;10(7):410. doi: 10.21037/atm-22-812.
BACKGROUND
Acute pancreatitis (AP) is characterized by acute onset, rapid development, and poor prognosis. Timely diagnosis and identification of the cause are the key to formulating the clinical program and improving the prognosis. There were several studies on this topic but the results varied. This study systematically evaluated and analyzed reports on the comparison of magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of AP in recent years, providing evidence for clinical diagnosis and treatment.
METHODS
The databases of PubMed, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched for literature on MRI and CT in the diagnosis of AP. After evaluating the articles and extracting the data, the software RevMan 5.4 and Stata 16.0 were used for meta-analysis.
RESULTS
A total of 9 articles were included in the selection, with a total of 566 patients having undergone diagnosis. Meta-analysis showed that for MRI, the diagnostic sensitivity was 92%, 95% confidence interval (CI): 85% to 96%; specificity was 74%, 95% CI: 50% to 89%; positive likelihood ratio was 3.5, 95% CI: 1.6 to 8.0; negative likelihood ratio was 0.11, 95% CI: 0.05 to 0.24; diagnostic odds ratio (DOR) was 32, 95% CI: 7 to 136; and the area under the curve (AUC) value was 0.93, 95% CI: 0.90 to 0.95. For CT, the diagnostic sensitivity was 73%, 95% CI: 55% to 85%; specificity was 64%, 95% CI: 42% to 82%; positive likelihood ratio was 2.0, 95% CI: 1.1 to 3.6; negative likelihood ratio was 0.43, 95% CI: 0.24 to 0.76; DOR was 5, 95% CI: 2 to 14; and the AUC value was 0.74, 95% CI: 0.70 to 0.78. The AUC value of MRI was significantly greater than CT (Z=3.684, P=0.023).
DISCUSSION
In the diagnosis of AP, MRI is more sensitive, specific, and accurate than CT, and can be used as the first choice for the diagnosis of AP.
背景
急性胰腺炎（AP）具有起病急、发展快、预后差的特点。及时诊断并明确病因是制定临床方案及改善预后的关键。关于这一主题已有多项研究，但结果各异。本研究系统评价并分析了近年来磁共振成像（MRI）与计算机断层扫描（CT）用于诊断AP的对比研究报告，为临床诊断和治疗提供依据。
方法
检索PubMed、Web of Science、Cochrane图书馆、中国知网（CNKI）和万方数据等数据库中关于MRI和CT诊断AP的文献。在对文章进行评估并提取数据后，使用RevMan 5.4软件和Stata 16.0软件进行荟萃分析。
结果
共纳入9篇文章，总计566例患者接受了诊断。荟萃分析显示，对于MRI，诊断敏感性为92%，95%置信区间（CI）：85%至96%；特异性为74%，95% CI：50%至89%；阳性似然比为3.5，95% CI：1.6至8.0；阴性似然比为0.11，95% CI：0.05至0.24；诊断比值比（DOR）为32，95% CI：7至136；曲线下面积（AUC）值为0.93，95% CI：0.90至0.95。对于CT，诊断敏感性为73%，95% CI：55%至85%；特异性为64%，95% CI：42%至82%；阳性似然比为2.0，95% CI：1.1至3.6；阴性似然比为0.43，95% CI：0.24至0.
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