钆塞酸二钠增强MRI在肝硬化背景下对肝癌诊断价值的Meta分析  

Gadoxetic Acid Disodium-Enhanced Magnetic Resonance Imaging for the Detection of Hepatocellular Carcinoma in Patients with Cirrhosis-A Systematic Review and Meta-Analysis

作　　者：张凌[1] 梁娜[1] 范萍[2] 

机构地区：[1]成都市第二人民医院影像科,四川成都610017 [2]成都军区总医院干部病房,四川成都610083

出　　处：《四川医学》2015年第11期1583-1586,共4页Sichuan Medical Journal

摘　　要：目的对钆塞酸二钠增强MRI在肝硬化背景下诊断原发型肝癌的文献进行荟萃分析,评价钆塞酸二钠增强MRI在肝硬化背景下诊断原发型肝癌的价值。方法检索数据库包括MEDLINE,EMBASE,Cochrane Library databases,检索时间为2000年1月到2015年3月。提取相关数据,采用Stata 12.0及Meta-Disc 1.4软件进行Meta分析。结果最终纳入16篇参考文献,共计2474个病灶。Meta分析结果示,钆塞酸二钠增强MRI在肝硬化背景下诊断原发型肝癌的敏感性、特异性、曲线下面积分别为0.921(95%CI:0.887,0.946),0.909(95%CI:0.823,0.955)和0.96(95%CI:0.94,0.97)。结论钆塞酸二钠增强MRI诊断原发型肝癌具有较高的诊断效能,但仍需大样本设计良好的研究进一步证实其临床运用价值。Objective To perform a systematic review and meta-analysis of the diagnostic performance of gadoxetic acid disodium（ Gd-EOB-DTPA）- enhanced magnetic resonance imaging（ MRI） as noninvasive modality for evaluating hepatocellular carcinoma（ HCC） in patients with cirrhosis. Methods Databases including MEDLINE,EMBASE,and Cochrane Library databases were searched for relevant original articles published from January 2000 to March 2015. Sensitivities,specificities,and areas under the receiver operating characteristic curve（ AUC） were calculated. Potential threshold effect,heterogeneity,and publication bias were investigated. Results Across 16 studies of 2474 lesions were included. The overall per-lesion Gd-EOB-DTPA- enhanced MRI sensitivity was 0. 921（ 95% CI： 0. 887,0. 946）,and specificity was 0. 909（ 95% CI： 0. 823,0. 955）. The area under the curve of the summary receiver operator characteristic（ ROC） was 0. 96（ 95% CI： 0. 94,0. 97）. Conclusion MRI with gadoxetic acid disodium is a noninvasive and no radiation exposure imaging modality with high sensitivity and specificity for the detection of HCC in patients with cirrhosis. Nonetheless,large-scale well-designed trials are necessary to assess its clinical value.

关 键 词：钆塞酸二钠 肝细胞肝癌 META分析 

分 类 号：R735.7[医药卫生—肿瘤]