Value of Magnetic Resonance Imaging in Characterizing Cirrhosis-Related Nodules: A Meta-Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGWei-wei , TANGJing , HUANGZi-xing ,  SONGBin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Cirrhosis-related nodule; Magnetic resonance imaging; CT; Meta-analysis; Case-control study

DOI：

10.7507/1007-9424.20140059

Video：

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Objective To evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) in characterizing cirrhosis-related nodules. Methods The databases such as the Cochrane Library, PubMed, EMbase were searched on computer from 1998 to 2012.The reviewers screened the trials according to strict inclusion and exclusion criteria, extracted the data, and assessed the methodology quality.Meta-analysis was performed using the metadisc 1.40 software.The acquired pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curve were used to describe the diagnostic value.The pooled likelihood ratio was calculated based on the pooled sensitivity and specificity. Results Six case-control studies involving 917 patients diagnosed with cirrhosis who were suspected to have hepatic nodules were included and 776 masses were confirmed by the biopsy or postoperative histopathology.The pooled statistical results of meta-analysis showed that the sensitivity and specificity of MRI were 87%(83%-89%) and 79%(73%-84%) respectively, the positive and negative likelihood ratios of MRI were 3.95 and 0.18 respectively, and the area under the SROC curve (AUC) was 0.895 6.The sensitivity and specificity of CT were 69%(65%-73%) and 83%(77%-88%) respectively, the positive and negative likelihood ratios of CT were 3.29 and 0.42 respectively, and the AUC was 0.728 7.The sensitivity, positive likehood ratio, and accuracy of MRI in characterizing cirrhosis-related nodules were higher than those of CT. Conclusion According these evidences, the MRI should be the first imaging examination for qualitative diagnosis of cirrhosis-related nodules.

Citation： ZHANGWei-wei, TANGJing, HUANGZi-xing, SONGBin. Value of Magnetic Resonance Imaging in Characterizing Cirrhosis-Related Nodules: A Meta-Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(2): 240-245. doi: 10.7507/1007-9424.20140059 Copy

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1. Gomma AI, Khan SA, Toledano MB, et al.hepatocellular carcinoma:epidemiology, risk factors and pathogenesis[J].World J Gastroenterol, 2008, 14(27):4300-4308.
2. But DY, Lai CL, Yuen MF.Natural history of hepatitis-related hepatocellular carcinoma[J].World J Gastroenterol, 2008, 14(11):1652-1656.
3. Higgins, Green S.Cochrane handbook for systematic reviews of interventions version 5.0.2[updated september 2009][EB/OL]. The Cochrane Collaboration, 2009 Available from www.cochrane-handbookorg.
4. Zamora J, Abraira V, Muriel A, et al.Meta-DiSc:a software for meta-analysis of test accuracy data[J].BMC Medical Research Methodology, 2006, 6:31.
5. Sersté T, Barrau V, Ozenne V, et al.Accuracy and disagreement of computed tomography and magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma and dysplastic nodules:role of biopsy[J].Hepatology, 2012, 55(3):800-806.
6. Pitton MB, Kloeckner R, Herber S, et al.MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma[J].World J Gastroenterol, 2009, 15(48):6044-6051.
7. Golfieri R, Marini E, Bazzocchi A, et al.Small ( < or=3 cm) hepatocellular carcinoma in cirrhosis:the role of double contrast agents in MR imaging vs.multidetector-row CT[J].Radiol Med, 2009, 114(8):1239-1266.
8. Yu NC, Chaudhari V, Raman SS, et al.CT and MRI improve detection of hepatocellular carcinoma, compared with ultrasound alone, in patients with cirrhosis[J].Clin Gastroenterol Hepatol, 2011, 9(2):161-167.
9. Rode A, Bancel B, Douek P, et al.Small nodule detection in cirrhotic livers:evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver[J].J Comput Assist Tomogr, 2001, 25(3):327-336.
10. Kim YK, Kwak HS, Kim CS, et al.Hepatocellular carcinoma in patients with chronic liver disease:comparison of SPIO-enhanced MR imaging and 16-detector row CT[J].Radiology, 2006, 238(2):531-541.
11. Takayasu K, Muramatsu Y, Mizuguchi Y, et al.Imaging of early hepatocellular carcinoma and adenomatous hyperplasia (dysplastic nodules) with dynamic ct and a combination of CT and angiography:experience with resected liver specimens[J].Intervirology, 2004, 47(3-5):199-208.
12. Bruegel M, Holzapfel K, Gaa J, et al.Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique[J].Eur Radiol, 2008, 18(3):477-485.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Magnetic Resonance Imaging in Characterizing Cirrhosis-Related Nodules: A Meta-Analysis

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