Superparamagnetic iron oxide-enhanced magnetic resonance imaging for focal hepatic lesions: Systematic review and meta-analysis
Superparamagnetic iron oxide-enhanced magnetic resonance imaging for focal hepatic lesions: Systematic review and meta-analysis
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DOI：
10.3748/wjg.v21.i14.4334
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发表时间：
2015-04-14
影响因子：
4.3
通讯作者：
Zhang, Zong-Ming
中科院分区：
文献类型：
--
作者：
Li, You-Wei;Chen, Zheng-Guang;Zhang, Zong-Ming
目的：评价超磁氧化铁(SPIO)增强磁共振成像(MRI)在肝局灶性病变(FHL)诊断和定性中的作用。方法：通过检索PubMed、EMBASE和Cochrane图书馆1988年1月至2014年9月发表的符合以下标准的文章，对相关研究进行荟萃分析：(1)SPIO增强MRI用于FHL的诊断，且Meta-Disk 1.4的数据足以用于合并分析；(2)肝细胞癌(HC)与其他FHL鉴别；(3)高分化型(WD-HC)与发育不良结节(WD-HC)的区别；(4)WD-HC与中、低分化型(MD-和PDHCs)的比较。结果：15项符合条件的研究结果显示，WD-HC与其他FHL鉴别的敏感度为85%，特异度为78%。排除非肝细胞癌时，灵敏度不变，特异度提高到87%。7项研究的WD-HC与MD-和PD-HC的对比分析显示，诊断MD-和PD-HC的敏感性为98%，特异性为50%，受试者工作特征(SROC)曲线下面积为0.97。与发育不良结节比较，诊断肝细胞癌的敏感性为50%，特异性为92%，SROC曲线下面积为0.80。结论：SPIO增强MRI对鉴别肝细胞癌和其他FHL有一定价值。
AIM: To evaluate the performance of superpara-magnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the detection and characterization of focal hepatic lesions (FHLs).METHODS: This meta-analysis compared relevant studies that were identified by searching PubMed, EMBASE, and the Cochrane Library databases for articles published between January 1988 and September 2014 and that met the following criteria: (1) SPIO-enhanced MRI was conducted to identify FHLs and data were sufficient for pooled analysis using Meta-DiSc 1.4; (2) hepatocellular carcinomas (HCCs) were differentiated from other FHLs; (3) well-differentiated HCCs (WD-HCCs) were contradistinguished from dysplastic nodules; and (4) WD-HCCs were compared with moderately and poorly differentiated HCCs (MD-and PDHCCs, respectively).RESULTS: The data obtained from 15 eligible studies yielded a sensitivity of 85% and a specificity of 78% for differentiating between HCCs and other FHLs. The sensitivity was unchanged and the specificity was increased to 87% when non-HCC malignancies were excluded. Comparative analyses between WD-HCCs and MD-and PD-HCCs from seven studies showed a sensitivity of 98% and a specificity of 50% for the diagnosis of MD-and PD-HCCs, and the area under the summary receiver operating characteristics (sROC) curve was 0.97. A comparison between WD-HCCs and dysplastic nodules revealed a sensitivity of 50% and a specificity of 92% for the diagnosis of WD-HCCs and the area under the sROC curve was 0.80.CONCLUSION: SPIO-enhanced MRI is useful in differentiating between HCCs and other FHLs.