Is Functional MR Imaging Assessment of Hemispheric Language Dominance as Good as the Wada Test?: A Meta-Analysis
Is Functional MR Imaging Assessment of Hemispheric Language Dominance as Good as the Wada Test?: A Meta-Analysis
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DOI：
10.1148/radiol.11101344
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发表时间：
2011-11-01
期刊：
影响因子：
19.7
通讯作者：
Lipton, Michael L.
中科院分区：
文献类型：
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作者：
Dym, R. Joshua;Burns, Judah;Lipton, Michael L.
目的：进行系统回顾和荟萃分析，以与 Wada 测试相比，定量评估语言功能的功能磁共振 (MR) 成像偏侧化。材料和方法：本研究被确定免于机构审查委员会的审查。根据系统评价和荟萃分析指南的首选报告项目进行了系统评价和荟萃分析。进行了结构化 Medline 搜索，以识别所有将功能性 MR 成像与 Wada 测试进行比较的研究，以确定脑部手术前的半球语言优势。符合预定纳入标准的研究由两名放射科医生独立选择，他们还使用诊断准确性研究质量评估工具评估其质量。每个患者的语言优势被分为典型（左半球语言优势）或非典型（右半球语言优势或双边语言表征）。然后使用双变量随机效应模型进行荟萃分析，以得出敏感性和特异性的估计值，并以世界反兴奋剂机构作为参考标准。还进行了亚组分析，以比较研究中使用的不同功能 MR 成像技术。结果：23 项研究（包括 442 名患者）符合纳入标准。功能性 MR 成像对非典型语言优势的敏感性和特异性（与 Wada 测试相比）分别为 83.5%（95% 置信区间：80.2%、86.7%）和 88.1%（95% 置信区间：87.0%、89.2%）。结论：功能 MR 成像为语言偏侧化提供了一种极好的、无创的替代方案，应在术前初始考虑 半球语言优势的评估。进一步的研究可能有助于确定哪些功能性 MR 方法对于特定患者群体最准确。 (C) 北美放射学会，2011
Purpose: To perform a systematic review and meta-analysis to quantitatively assess functional magnetic resonance (MR) imaging lateralization of language function in comparison with the Wada test.Materials and Methods: This study was determined to be exempt from review by the institutional review board. A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A structured Medline search was conducted to identify all studies that compared functional MR imaging with the Wada test for determining hemispheric language dominance prior to brain surgery. Studies meeting predetermined inclusion criteria were selected independently by two radiologists who also assessed their quality using the Quality Assessment of Diagnostic Accuracy Studies tool. Language dominance was classified as typical (left hemispheric language dominance) or atypical (right hemispheric language dominance or bilateral language representation) for each patient. A meta-analysis was then performed by using a bivariate random-effects model to derive estimates of sensitivity and specificity, with Wada as the standard of reference. Subgroup analyses were also performed to compare the different functional MR imaging techniques utilized by the studies.Results: Twenty-three studies, comprising 442 patients, met inclusion criteria. The sensitivity and specificity of functional MR imaging for atypical language dominance (compared with the Wada test) were 83.5% (95% confidence interval: 80.2%, 86.7%) and 88.1% (95% confidence interval: 87.0%, 89.2%), respectively.Conclusion: Functional MR imaging provides an excellent, noninvasive alternative for language lateralization and should be considered for the initial preoperative assessment of hemispheric language dominance. Further research may help determine which functional MR methods are most accurate for specific patient populations. (C) RSNA, 2011