Accuracy of MR Imaging and MR Spectroscopy for Detection and Quantification of Hepatic Steatosis in Living Liver Donors: A Meta-Analysis
Accuracy of MR Imaging and MR Spectroscopy for Detection and Quantification of Hepatic Steatosis in Living Liver Donors: A Meta-Analysis
复制标题
磁共振成像和磁共振波谱检测和定量活体肝脏捐献者肝脏脂肪变性的准确性：荟萃分析
DOI：
10.1148/radiol.2016152571
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发表时间：
2017-01-01
期刊：
影响因子：
19.7
通讯作者：
He, Xiaoshun
中科院分区：
文献类型：
--
作者：
Zheng, Danping;Guo, Zhiyong;He, Xiaoshun
目的：为了确定准确性的磁共振（MR）成像检测和定量肝脂肪变性（HS）在活的liver donor candidates.Materials and Methods：进行了系统的文献检索，以找到研究的诊断和定量准确性的MR成像评估HS在肝脏供体。使用诊断准确性研究2工具的质量评估，并评估患者选择、索引文本、参考标准以及研究流程和时间，以评价每项纳入研究的质量。汇总的敏感性，特异性，阳性和阴性似然比，分层汇总受试者工作特征（ROC）曲线，并通过使用分层汇总ROC和双变量随机效应models.Results的曲线下面积估计：8项研究，涉及934名受试者有资格进行荟萃分析。在活体肝脏供体中，MR成像和/或MR波谱检测HS的合并灵敏度、特异性、阳性似然比和阴性似然比分别为0.89（95%置信区间[CI]：0.75，0.95）、0.84（95% CI：0.76，0.89）、5.53（95% CI：3.71，8.25）和0.14（95% CI：0.06，0.31）。曲线下面积为0.92（95% CI：0.89，0.94）。用于检测大量HS（根据每项研究的定义，肝脏病理检查时HS>10%至>30%），这些相应的诊断估计值为0.91（95% CI：0.82，0.95）、0.89（95% CI：0.84，0.93）、8.30（95% CI：5.47，12.59）、0.10（95% CI：0.05，0.21）和0.96（95% CI：0.93，0.97）。检测到中度异质性。结论：MR成像和MR波谱对HS的检测具有较高的敏感性和特异性，特别是当HS是实质性的，并可能是有用的无创评估活体肝供体HS。(C)RSNA，2016
Purpose: To determine the accuracy of magnetic resonance (MR) imaging for detection and quantification of hepatic steatosis (HS) in living liver donor candidates.Materials and Methods: A systematic search of the literature was performed to find studies on the diagnostic and quantitative accuracy of MR imaging for assessment of HS in liver donors. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used, and patient selection, index text, reference standard, and study flow and timing were assessed to evaluate the quality of each included study. Pooled sensitivity, specificity, positive and negative likelihood ratios, hierarchical summary receiver operating characteristic (ROC) curves, and the area under the curve were estimated by using hierarchical summary ROC and bivariate random-effects models.Results: Eight studies involving 934 subjects were eligible for the meta-analysis. For detection of HS with MR imaging and/or MR spectroscopy in living liver donors, the pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio, respectively, were 0.89 (95% confidence interval [CI]: 0.75,0.95), 0.84 (95% CI: 0.76, 0.89), 5.53 (95% CI: 3.71, 8.25), and 0.14 (95% CI: 0.06, 0.31). The area under the curve was 0.92 (95% CI: 0.89, 0.94). For detection of substantial HS (>10% to >30% HS at liver pathologic examination, as defined in each study), these corresponding diagnostic estimates were 0.91 (95% CI: 0.82, 0.95), 0.89 (95% CI: 0.84, 0.93), 8.30 (95% CI: 5.47, 12.59), 0.10 (95% CI: 0.05, 0.21), and 0.96 (95% CI: 0.93, 0.97), respectively. Moderate heterogeneity was detected. No publication bias was detected (P = .12).Conclusion: MR imaging and MR spectroscopy show high sensitivity and specificity for detection of HS, especially when HS is substantial, and may be useful for noninvasive evaluation of HS in living liver donors. (C) RSNA, 2016