Aldossari Reem M, Alkindi Muaiyad, Alshamrani Othman M, Abdullah Raghad E, Alosaimi Shaden M, Alsaleh Taghreed A, Babegi Joud M, Altabsh Mohammed A, Alhazmi Majed J, Alfawaz Salman M, Qasem Budur A, Alfaleh Hana
College of Medicine, King Saud University, Riyadh, SAU.
Division of Diagnostic Radiology, Oman Medical Specialty Board, Muscat, OMN.
Cureus. 2025 Jan 4;17(1):e76911. doi: 10.7759/cureus.76911. eCollection 2025 Jan.
Testicular cancer, while rare, is a common malignancy among males aged 15-45 years and often spreads to retroperitoneal lymph nodes. This systematic review and meta-analysis compares the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in detecting retroperitoneal lymph node metastasis. A comprehensive search was conducted up to January 25, 2024, using PubMed, MEDLINE, Web of Science, and Google Scholar. Studies comparing MRI and CT for detecting retroperitoneal lymph node involvement in adult males with testicular neoplasms were included. Data extraction covered study design, sample size, demographics, imaging techniques, and diagnostic outcomes. The Newcastle-Ottawa Scale was used to assess the risk of bias, and a random-effects model was applied for the meta-analysis. A total of 618 articles were identified, with four meeting the inclusion criteria. The studies reported high sensitivity for both MRI and CT, with MRI sensitivities ranging from 97% to 100% and CT sensitivities from 96% to 100%. Specificity findings were variable, with some studies suggesting similar or slightly higher values for MRI. Meta-analysis of three studies revealed no significant difference between MRI and CT in detecting retroperitoneal lymph node metastasis, with an odds ratio of 1.00 (95% CI: 0.54 to 1.86) and minimal heterogeneity (I² = 0%). These findings suggest both MRI and CT demonstrate comparable diagnostic accuracy in detecting retroperitoneal lymph node metastasis in testicular cancer. While MRI avoids ionizing radiation, it requires expert interpretation and is more costly, limiting its accessibility in some settings.
睾丸癌虽然罕见，但却是15至45岁男性中常见的恶性肿瘤，且常转移至腹膜后淋巴结。本系统评价和荟萃分析比较了磁共振成像（MRI）和计算机断层扫描（CT）在检测腹膜后淋巴结转移方面的诊断准确性。截至2024年1月25日，使用PubMed、MEDLINE、科学网和谷歌学术进行了全面检索。纳入了比较MRI和CT检测成年男性睾丸肿瘤腹膜后淋巴结受累情况的研究。数据提取涵盖研究设计、样本量、人口统计学、成像技术和诊断结果。采用纽卡斯尔-渥太华量表评估偏倚风险，并应用随机效应模型进行荟萃分析。共识别出618篇文章，其中4篇符合纳入标准。研究报告MRI和CT均具有高敏感性，MRI敏感性范围为97%至100%，CT敏感性范围为96%至100%。特异性结果各不相同，一些研究表明MRI的值相似或略高。对三项研究的荟萃分析显示，MRI和CT在检测腹膜后淋巴结转移方面无显著差异，优势比为1.00（95%CI：0.54至1.86），异质性最小（I² = 0%）。这些发现表明，MRI和CT在检测睾丸癌腹膜后淋巴结转移方面具有相当的诊断准确性。虽然MRI可避免电离辐射，但它需要专家解读且成本更高，在某些情况下限制了其可及性。
