Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria, Madrid, España.
Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
Med Clin (Barc). 2024 Dec 13;163(11):533-548. doi: 10.1016/j.medcli.2024.05.028. Epub 2024 Sep 7.
Magnetic resonance imaging (MRI) is a frequently used test in the diagnosis of dementia. The objective was to evaluate its effectiveness for the early diagnosis of dementia in patients with mild cognitive impairment (MCI).
Original studies were selected from systematic reviews between 2011 and 2021, according to PRISMA 2020 criteria. QUADAS-2 and GRADE tools were used, and a meta-analysis was performed.
Final selection of 23 articles. Patient selection and index test had a high probability of bias. The certainty of the evidence was very low. In the hippocampus, sensitivity was 0.62 (95%CI 0.48-0.79) and specificity 0.70 (95%CI 0.55-0.80). In the temporal lobe, sensitivity was 0.65 (range 0.45) and specificity 0.69 (range 0.32).
There is insufficient evidence to recommend routine brain MRI for the early diagnosis of dementia in patients with MCI.
磁共振成像（MRI）是诊断痴呆症的常用检测方法。本研究旨在评估 MRI 对轻度认知障碍（MCI）患者痴呆症早期诊断的有效性。
根据 PRISMA 2020 标准，从 2011 年至 2021 年的系统评价中选择原始研究。使用 QUADAS-2 和 GRADE 工具进行评估，并进行荟萃分析。
最终选择了 23 篇文章。患者选择和指标检测存在高偏倚风险。证据的确定性非常低。在海马体中，敏感度为 0.62（95%CI 0.48-0.79），特异性为 0.70（95%CI 0.55-0.80）。在颞叶中，敏感度为 0.65（范围 0.45），特异性为 0.69（范围 0.32）。
目前尚无足够证据推荐对 MCI 患者常规行脑 MRI 检查以早期诊断痴呆症。
