Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis
Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis
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MRI 评估直肠癌患者直肠系膜筋膜受累情况的有效性：系统评价和荟萃分析
DOI：
10.1159/000363075
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发表时间：
2014
影响因子：
2.7
通讯作者：
W. Fu
中科院分区：
文献类型：
--
作者：
Haiting Xie;Xin Zhou;Zize Zhuo;S. Che;Lingduo Xie;W. Fu
目标：通过回顾文献和使用新的入选标准来定义直肠系膜筋膜受累（MRF+）的最适当定义，以重新评价MRI在评估直肠癌MRF+中的有效性。方法：电子检索1999年至2012年的PubMed、Medline、Embase和科克伦图书馆数据库。使用双变量随机效应模型估计每个亚组的汇总结局。特别讨论了MRI中MRF+的定义和新辅助放化疗（neo-ChRT）的影响。结果：纳入了14项研究，涉及1，600例患者。MRI中MRF+（≤1、≤2和≤5 mm）的不同定义显示出不同的合并灵敏度（76、79和92%）、特异性（88、66和48%）和诊断比值比（DOR）（22.4、6.6和16.0）。≤1 mm处的MRF+定义显示最高DOR。接受neo-ChRT的患者的特异性（88 vs. 93%，p = 0.026）和DOR（15.5 vs. 39.0，p = 0.001）低于未接受neo-ChRT的患者，同时使用≤1 mm作为MRF+的定义。然而，灵敏度显示无显著差异（67 vs. 74%，p = 0.129）。结论：MRI对MRF的诊断有重要价值。MRI中MRF+的最适当定义为≤1 mm。未接受neo-ChRT的患者的有效性更高。
Aims: Defining the most appropriate definition of mesorectal fascia involvement (MRF+) by reviewing literature and using new inclusion criteria to re-evaluate the effectiveness of MRI in the assessment of MRF+ for rectal cancer. Methods: PubMed, Medline, Embase, and the Cochrane Library databases were electronically searched from 1999 to 2012. The bivariate random effects model was used to estimate the pooled outcomes of each subgroup. The definition of MRF+ in MRI and the influence of neoadjuvant chemoradiotherapy (neo-ChRT) were especially discussed. Results: Fourteen studies involving 1,600 patients were included. Different definitions of MRF+ (≤1, ≤2 and ≤5 mm) in MRI exhibited different pooled sensitivity (76, 79 and 92%), specificity (88, 66 and 48%) and diagnostic odds ratio (DOR) (22.4, 6.6 and 16.0). The definition of MRF+ at ≤1 mm showed the highest DOR. The specificity (88 vs. 93%, p = 0.026) and DOR (15.5 vs. 39.0, p = 0.001) were lower in patients who underwent neo-ChRT than those who did not while using ≤1 mm as the definition of MRF+. However, the sensitivity showed no significant difference (67 vs. 74%, p = 0.129). Conclusions: MRI is valuable for the assessment of MRF. The most appropriate definition of MRF+ in MRI is ≤1 mm. The effectiveness is higher in patients who did not undergo neo-ChRT.
影响因子：
45.3
作者：
Bosset, JF;Calais, G;Collette, L
通讯作者：
Collette, L