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心血管磁共振成像与组织病理学研究在诊断心脏良恶性肿瘤中的应用:一项系统评价与荟萃分析

Cardiovascular Magnetic Resonance Versus Histopathologic Study for Diagnosis of Benign and Malignant Cardiac Tumours: A Systematic Review and Meta-Analysis.

作者信息

Nóbrega Sandra, Martins da Costa Catarina, Amador Ana Filipa, Justo Sofia, Martins Elisabete

机构信息

Faculty of Medicine, University of Porto, Porto, Portugal.

Department of Cardiology, Centro Hospitalar Universitário São João, Porto, Portugal.

出版信息

J Cardiovasc Imaging. 2023 Oct;31(4):159-168. doi: 10.4250/jcvi.2023.0028.

Abstract

BACKGROUND

The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard.

METHODS

A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health.

RESULTS

A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis.

CONCLUSIONS

To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.

摘要

背景

心脏肿瘤诊断的金标准是组织病理学检查。心血管磁共振成像(CMR)是一种用于识别和表征心脏肿瘤的有价值的非侵入性、无辐射工具。我们的目的是通过与金标准比较来区分良性与恶性肿瘤,从而了解CMR对心脏肿瘤的诊断情况。

方法

截至2022年12月,在PubMed、科学网和Scopus数据库中进行了系统检索,结果由2名独立研究者进行审查。纳入报告CMR诊断的研究进行荟萃分析,并获得合并测量值。使用美国国立卫生研究院的质量评估工具评估偏倚风险。

结果

共获得2321条结果;10项研究符合条件,其中1项通过引文检索确定。8项研究纳入荟萃分析,CMR诊断良性与恶性肿瘤的合并敏感性为93%,特异性为94%,诊断比值比为185,曲线下面积为0.98。此外,4项研究评估了CMR对心脏肿瘤的诊断是否与特定组织病理学亚型匹配,73.6%的研究实现了正确诊断。

结论

据我们所知,这是首次发表的关于CMR诊断心脏肿瘤的系统评价。与组织病理学结果相比,区分良性与恶性肿瘤的能力良好但并不突出。然而,显著的异质性可能对我们的研究结果产生了影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d230/10622638/f5edd35b80c3/jcvi-31-159-g001.jpg

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