Computed tomography vs liver stiffness measurement and magnetic resonance imaging in evaluating esophageal varices in cirrhotic patients:A systematic review and meta-analysis  

作　　者：Yue Li Lei Li Hong-Lei Weng Roman Liebe Hui-Guo Ding 

机构地区：[1]Department of Gastroenterology and Hepatology,Beijing You’an Hospital Affiliated with Capital Medical University,Beijing 100069,China [2]Department of Medicine Ⅱ,Section Molecular Hepatology,Medical Faculty Mannheim,Heidelberg University,Mannheim 68167,Germany [3]Department of Medicine Ⅱ,Saarland University Medical Center,Homburg 66424,Germany

出　　处：《World Journal of Gastroenterology》2020年第18期2247-2267,共21页世界胃肠病学杂志（英文版）

基　　金：Supported by the State Key Projects Specialized on Infectious Diseases,No.2017ZX10203202–004;Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding,No.ZYLX201610;Beijing Municipal Administration of Hospitals’Ascent Plan,No.DFL20151602;Digestive Medical Coordinated Development Center of Beijing Hospitals Authority,No.XXT24.

摘　　要：BACKGROUND Computed tomography(CT),liver stiffness measurement(LSM),and magnetic resonance imaging(MRI)are non-invasive diagnostic methods for esophageal varices(EV)and for the prediction of high-bleeding-risk EV(HREV)in cirrhotic patients.However,the clinical use of these methods is controversial.AIM To evaluate the accuracy of LSM,CT,and MRI in diagnosing EV and predicting HREV in cirrhotic patients.METHODS We performed literature searches in multiple databases,including Pub Med,Embase,Cochrane,CNKI,and Wanfang databases,for articles that evaluated the accuracy of LSM,CT,and MRI as candidates for the diagnosis of EV and prediction of HREV in cirrhotic patients.Summary sensitivity and specificity,positive likelihood ratio and negative likelihood ratio,diagnostic odds ratio,and the areas under the summary receiver operating characteristic curves were analyzed.The quality of the articles was assessed using the quality assessment of diagnostic accuracy studies-2 tool.Heterogeneity was examined by Q-statistic test and I2 index,and sources of heterogeneity were explored using metaregression and subgroup analysis.Publication bias was evaluated using Deek’s funnel plot.All statistical analyses were conducted using Stata12.0,Meta Disc1.4,and Rev Man5.3.RESULTS Overall,18,17,and 7 relevant articles on the accuracy of LSM,CT,and MRI in evaluating EV and HREV were retrieved.A significant heterogeneity was observed in all analyses(P<0.05).The areas under the summary receiver operating characteristic curves of LSM,CT,and MRI in diagnosing EV and predicting HREV were 0.86(95%confidence interval[CI]:0.83-0.89),0.91(95%CI:0.88-0.93),and 0.86(95%CI:0.83-0.89),and 0.85(95%CI:0.81-0.88),0.94(95%CI:0.91-0.96),and 0.83(95%CI:0.79-0.86),respectively,with sensitivities of 0.84(95%CI:0.78-0.89),0.91(95%CI:0.87-0.94),and 0.81(95%CI:0.76-0.86),and 0.81(95%CI:0.75-0.86),0.88(95%CI:0.82-0.92),and 0.80(95%CI:0.72-0.86),and specificities of 0.71(95%CI:0.60-0.80),0.75(95%CI:0.68-0.82),and 0.82(95%CI:0.70-0.89),and 0.73(95%CI:0.66-0.80),0.87

关 键 词：Multidetector computed tomography imaging Magnetic resonance imaging Liver stiffness measurement Liver cirrhosis Esophageal varices META-ANALYSIS 

分 类 号：R575.2[医药卫生—消化系统]