The Use of the Central Vein Sign in the Diagnosis of Multiple Sclerosis: A Systematic Review and Meta-analysis.
The Use of the Central Vein Sign in the Diagnosis of Multiple Sclerosis: A Systematic Review and Meta-analysis.
复制标题
中央静脉征在多发性硬化诊断中的应用：系统评价和荟萃分析。
DOI：
10.3390/diagnostics10121025
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发表时间：
2020-11-29
期刊：
影响因子：
--
通讯作者：
Calabrese M
中科院分区：
文献类型：
--
作者：
Castellaro M;Tamanti A;Pisani AI;Pizzini FB;Crescenzo F;Calabrese M
背景资料：中央静脉征（CVS）是一种放射学特征，建议作为多发性硬化（MS）成像生物标志物，能够准确区分MS与其他中枢神经系统白色疾病。在这项工作中，我们评估了脑MS病变中CVS的合并比例，并估计CVS诊断MS的诊断性能，并提出了最佳截止值。方法：对截至2020年8月24日的公开数据库（PUBMED/MEDLINE和Web of Science）进行了系统检索。使用双变量随机效应模型分析了具有中心静脉的白色MS病变的比例。进行了荟萃回归分析，并研究了使用特定序列（如3D回波平面成像）和后处理技术（如FLAIR*）的影响。使用双变量模型估计合并的敏感性和特异性，并进行荟萃回归以解决异质性。采用不对称检验和漏斗图评估入选和发表偏倚。分层汇总受试者工作曲线（HSROC）用于评估诊断性能的汇总准确性。使用个体患者数据，采用Youden指数估计最佳临界值。结果：MS人群中显示CVS的病变合并比例为73%。CVS的使用在MS病例中显示出显著的诊断性能，提供了92%的合并特异性和95%的灵敏度。从合并的个体患者数据中获得的最佳截止值为40%，通过ROC下的面积（0.946）计算的准确性极佳。与其他序列相比，3D-EPI序列显示出更高的合并比例，并解释了诊断性能荟萃回归分析中的异质性。与3 T（74%）和7 T（82%）相比，1.5特斯拉（T）扫描仪显示的CVS MS病变比例较低（58%）。结论：我们进行的荟萃分析表明，使用CVS区分MS与其他模仿疾病是值得鼓励的;此外，使用专用序列，如3D-EPI和高MRI场是有益的。
Background: The central vein sign (CVS) is a radiological feature proposed as a multiple sclerosis (MS) imaging biomarker able to accurately differentiate MS from other white matter diseases of the central nervous system. In this work, we evaluated the pooled proportion of the CVS in brain MS lesions and to estimate the diagnostic performance of CVS to perform a diagnosis of MS and propose an optimal cut-off value. Methods: A systematic search was performed on publicly available databases (PUBMED/MEDLINE and Web of Science) up to 24 August 2020. Analysis of the proportion of white matter MS lesions with a central vein was performed using bivariate random-effect models. A meta-regression analysis was performed and the impact of using particular sequences (such as 3D echo-planar imaging) and post-processing techniques (such as FLAIR*) was investigated. Pooled sensibility and specificity were estimated using bivariate models and meta-regression was performed to address heterogeneity. Inclusion and publication bias were assessed using asymmetry tests and a funnel plot. A hierarchical summary receiver operating curve (HSROC) was used to estimate the summary accuracy in diagnostic performance. The Youden index was employed to estimate the optimal cut-off value using individual patient data. Results: The pooled proportion of lesions showing a CVS in the MS population was 73%. The use of the CVS showed a remarkable diagnostic performance in MS cases, providing a pooled specificity of 92% and a sensitivity of 95%. The optimal cut-off value obtained from the individual patient data pooled together was 40% with excellent accuracy calculated by the area under the ROC (0.946). The 3D-EPI sequences showed both a higher pooled proportion compared to other sequences and explained heterogeneity in the meta-regression analysis of diagnostic performances. The 1.5 Tesla (T) scanners showed a lower (58%) proportion of MS lesions with a CVS compared to both 3T (74%) and 7T (82%). Conclusions: The meta-analysis we have performed shows that the use of the CVS in differentiating MS from other mimicking diseases is encouraged; moreover, the use of dedicated sequences such as 3D-EPI and the high MRI field is beneficial.
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影响因子：
3.3
作者：
Gabr RE;Pednekar AS;Kamali A;Lincoln JA;Nelson FM;Wolinsky JS;Narayana PA
通讯作者：
Narayana PA
影响因子：
3.4
作者：
Eisele, Philipp;Fischer, Katja;Gass, Achim
通讯作者：
Gass, Achim
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
3.5
作者：
Hosseini, Z.;Matusinec, J.;Drangova, M.
通讯作者：
Drangova, M.
DOI：
10.1016/j.ejrnm.2017.09.003
发表时间：
2018-03-01
影响因子：
1
作者：
Al-Zandi, Shirin H.;Fayadh, Noor A. H.;Al-Waely, Noor K. N.
通讯作者：
Al-Waely, Noor K. N.