Diagnostic value of MR for pulmonary embolism: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

SHEN Chen ¹ , SHANG Wenbo ¹ , CHEN Zhangmin ¹ , ZHAO Teng ¹ ,  ZHANG Pengtian ²

1. College of Medical Technology, Shanxi University of Chinese Medicine, Xianyang, 712000, P.R.China;
2. Affiliated Hospital of Shanxi University of Chinese Medicine, Xianyang, 712000, P.R.China;

Corresponding author：

ZHANG Pengtian, Email: zhpeti@sina.com

Keywords：

Pulmonary embolism; Magnetic resonance; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.201612068

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ObjectiveTo systematic review the diagnostic value of magnetic resonance (MR) for pulmonary embolism (PE).MethodsWe electronically searched databases including EMbase, PubMed, The Cochrane Library, WanFang Data and CNKI from inception to November 2016, to collect the diagnostic studies about MR in the diagnosis of PE. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies, and then meta-analysis was conducted using Stata 12.0 software.ResultsA total of 14 studies involving 1 042 patients were included. The pooled Sen, Spe, +LR, –LR and DOR were 0.90 (95%CI 0.83 to 0.94), 0.95 (95%CI 0.90 to 0.98), 19.8 (95%CI 8.5 to 46.1), 0.10 (95%CI 0.06 to 0.18), 189 (95%CI 69 to 521), respectively. The AUC of SROC were 0.97 (95%CI 0.95 to 0.98).ConclusionMR has a good diagnosis value for PE which can be regarded as an effective and feasible method for suspected PE patients, especially for those who has contraindication of computed tomographic pulmonary angiography.

Citation： SHEN Chen, SHANG Wenbo, CHEN Zhangmin, ZHAO Teng, ZHANG Pengtian. Diagnostic value of MR for pulmonary embolism: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(7): 768-773. doi: 10.7507/1672-2531.201612068 Copy

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15.	Loubeyre P, Revel D, Douek P, et al. Dynamic contrast-enhanced Mr angiography of pulmonary embolism: comparison with pulmonary angiography. AJR Am J Roentgenol, 1994, 162(5): 1035-1039.
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17.	Gupta A, Frazer CK, Ferguson JM, et al. Acute pulmonary embolism: diagnosis with Mr angiography. Radiology, 1999, 210(2): 353-359.
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19.	陈耀龙, 于洁, 张文娟, 等. 循证医学术语介绍 VII. 中国循证医学杂志, 2009, 9(12): 1272-1276.
20.	Ley S. Imaging pulmonary arterial thromboembolism: challenges and opportunities. Magn Reson Imaging Clin N Am, 2015, 23(2): 261-271.
21.	王娜娜, 吕飙, 张兆琪, 等. MR 增强肺灌注成像对肺动脉栓塞治疗疗效评价的可行性及准确性. 中华放射学杂志, 2010, 44(5): 479-483.
22.	陈松, 杨如武, 郭佑民, 等. CT 和 MR 血管成像诊断急性肺栓塞的 Meta 分析. 放射学实践, 2014, 29(12): 1409-1414.

1. Authors/Task Force Members, Elliott PM, Anastasakis A, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European society of cardiology (ESC). Eur Heart J, 2014, 35(39): 2733-2779.
2. 安硕研, 樊朝美, 李一石. 造影剂肾病的研究现状. 中国临床药理学杂志, 2015, 31(13): 1331-1334.
3. Mccullough PA, Adam A, Becker CR, et al. Epidemiology and prognostic implications of contrast-induced nephropathy. Am J Cardiol, 2006, 98(6A): 5K-13K.
4. 中华医学会心血管病学分会肺血管病学组. 急性肺栓塞诊断与治疗中国专家共识(2015). 中华心血管病杂志, 2016, 44(3): 197-211.
5. 赵艳娥, 唐春香, 周长圣, 等. 3.0T MR 动态对比增强肺动脉成像评估肾病综合征患者肺栓塞. 放射学实践, 2016, 31(9): 833-837.
6. 于丽娟, 张雪林, 栾彧, 等. 3D DCE MRPA 诊断肺栓塞的临床应用研究. 放射学实践, 2005, 20(1): 28-31.
7. 孟志华, 卢雨零, 雷淑妃, 等. MR 三维增强肺动脉造影的临床应用. 中国误诊学杂志, 2005, 5(5): 833-836.
8. Zhang LJ, Luo S, Yeh BM, et al. Diagnostic accuracy of three-dimensional contrast-enhanced Mr angiography at 3-T for acute pulmonary embolism detection: comparison with multidetector CT angiography. Int J Cardiol, 2013, 168(5): 4775-4783.
9. Stein PD, Chenevert TL, Fowler SE, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med, 2010, 152(7): 434-443.
10. Schiebler ML, Nagle SK, François CJ, et al. Effectiveness of MR angiography for the primary diagnosis of acute pulmonary embolism: clinical outcomes at 3 months and 1 year. J Magn Reson Imaging, 2013, 38(4): 914-925.
11. Pleszewski B, Chartrand-Lefebvre C, Qanadli SD, et al. Gadolinium-enhanced pulmonary magnetic resonance angiography in the diagnosis of acute pulmonary embolism: a prospective study on 48 patients. Clin Imaging, 2006, 30(3): 166-172.
12. Oudkerk M, Van Beek EJ, Wielopolski P, et al. Comparison of contrast-enhanced magnetic resonance angiography and conventional pulmonary angiography for the diagnosis of pulmonary embolism: a prospective study. Lancet, 2002, 359(9318): 1643-1647.
13. Osman AM, Abdeldayem EH, Osman NM. MR pulmonary angiography: Can it be used as an alternative for CT angiography in diagnosis of major pulmonary thrombosis? Egypt J Radiol Nucle Med, 2016, 47(3): 803-810.
14. Meaney JF, Weg JG, Chenevert TL, et al. Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med, 1997, 336(20): 1422-1427.
15. Loubeyre P, Revel D, Douek P, et al. Dynamic contrast-enhanced Mr angiography of pulmonary embolism: comparison with pulmonary angiography. AJR Am J Roentgenol, 1994, 162(5): 1035-1039.
16. Kluge A, Luboldt W, Bachmann G. Acute pulmonary embolism to the subsegmental level: diagnostic accuracy of three MRI techniques compared with 16-MDCT. AJR Am J Roentgenol, 2006, 187(1): W7-14.
17. Gupta A, Frazer CK, Ferguson JM, et al. Acute pulmonary embolism: diagnosis with Mr angiography. Radiology, 1999, 210(2): 353-359.
18. Blum A, Bellou A, Guillemin F, et al. Performance of magnetic resonance angiography in suspected acute pulmonary embolism. Thromb Haemost, 2005, 93(3): 503-511.
19. 陈耀龙, 于洁, 张文娟, 等. 循证医学术语介绍 VII. 中国循证医学杂志, 2009, 9(12): 1272-1276.
20. Ley S. Imaging pulmonary arterial thromboembolism: challenges and opportunities. Magn Reson Imaging Clin N Am, 2015, 23(2): 261-271.
21. 王娜娜, 吕飙, 张兆琪, 等. MR 增强肺灌注成像对肺动脉栓塞治疗疗效评价的可行性及准确性. 中华放射学杂志, 2010, 44(5): 479-483.
22. 陈松, 杨如武, 郭佑民, 等. CT 和 MR 血管成像诊断急性肺栓塞的 Meta 分析. 放射学实践, 2014, 29(12): 1409-1414.

Chinese Journal of Evidence-Based Medicine

Diagnostic value of MR for pulmonary embolism: a meta-analysis

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