ObjectiveTo systematically review the diagnostic value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for liver metastases. MethodsWe searched databases including CNKI, CBM, VIP, WanFang Data, PubMed, EMbase and The Cochrane Library from January 2011 to December 2014 to collect diagnostic tests about Gd-EOB-DTPA for liver metastases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Then, meta-analysis was performed by using Stata 12.0 software. ResultsA total of 15 studies from seven countries were included, involving 2 040 nodules from 701 patients. The results of meta-analysis showed that, the pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic odds ratio (DOR) of Gd-EOB-DTPA for liver metastases were 0.92 (95%CI 0.89 to 0.95), 0.94 (95%CI 0.89 to 0.97), 14.51 (95%CI 8.01 to 26.28), 0.08 (95%CI 0.06 to 0.12), and 177.98 (95%CI 89.50 to 353.94), respectively. The area under curve (AUC) of SROC was 0.97 (95%CI 0.95 to 0.98). The results of subgroup analysis showed that Gd-EOB-DTPA had better Sen in nodules >10 mm than the nodules ≤10 mm in diameter (>10 mm: pooled Sen=0.97, 95%CI 0.94 to 0.99; ≤10 mm: pooled Sen=0.75, 95%CI 0.65 to 0.85; P<0.001); The 3.0T MR had better Sen in diagnosing liver metastases compared with 1.5T MR (3.0T: pooled Sen=0.95, 95%CI 0.92 to 0.97; 1.5T: pooled Sen=0.90, 95%CI 0.87 to 0.94; P<0.001). ConclusionGdEOB-DTPA is of value for the detection of liver metastases. In particular, it is of high sensitivity for the detection of nodules larger than 10 mm, and for the cases using 3.0T high-field MR system. Due to limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To observe the effect of ophthalmotonus intervention on ocular hemodynamics in patients with ischemic ophthalmopathy (IOP). Methods 106 IOP patients (106 eyes) were enrolled in this study, including 74 eyes with nonarteritic anterior ischemic optic neuropathy (NAION), 20 eyes with retinal artery occlusion (RAO) and 12 eyes with ocular ischemia syndrome (IOS). The patients were randomly divided into ophthalmotonus intervention group and control group. There were 37 NAION eyes, 10 RAO eyes and six IOS eyes in each group. The patients of ophthalmotonus intervention group received lowering intraocular pressure treatment in addition to the basic therapy to reduce the intraocular pressure to le;12 mm Hg (1 mm Hg=0.133 kPa) or decreased by 7-8 mm Hg, or in a 20%-30% reduction. The patients of control group avoided lowering intraocular pressure treatment. The arm-retinal circulation time (A-RCT) and the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and one week after treatment were comparatively analyzed by fluorescence fundus angiography (FFA) and color Doppler flow imaging. Results The differences of A-RCT before treatment in ophthalmotonus intervention group and control group in NAION, RAO and IOS patients were not statistically significant (t=0.869, 0.119, 0.000; P＞0.05). The differences of PSV (OA:t=0.586, 0.040, 0.067; CRA:t=0.285, 0.057, 0.775; PCA:t=0.658, 0.653, 1.253), EDV (OA:t=0.274, 0.080, 0.093; CRA:t=0.781, 0.077, 0.277; PCA:t=0.200, 0.209, 0.299) and RI (OA:t=0.121, 0.153, 0.138; CRA:t=0.172, 0.242, 0.642; PCA:t=1.053, 1.066, 0.266) of OA, CRA and PCA before treatment in ophthalmotonus intervention group and control group were not statistically significant (P＞0.05). Compared with control group, A-RCT shortened obviously (t=2.573, 2.236, 2.607; P＜0.05) in ophthalmotonus intervention group one week after treatment. Compared with control group, PSV (OA:t=2.367, 2.368, 2.267; CRA:t=0.775, 1.927, 2.775; PCA:t=2.253, 2.353, 2.353) and EDV (OA:t=2.303, 2.236, 2.503; CRA: t=2.277, 2.377, 2.577; PCA:t=2.299, 2.399, 2.299) of OA, CRA and PCA increased obviously (P＜0.05), RI of OA, CRA and PCA decreased obviously (OA:t=2.238, 2.387, 2.228; CRA:t=2.342, 2.442, 2.542; PCA:t=2.266, 2.366, 2.266; P＜0.05) one week after treatment in treatment group. Conclusion Ophthalmotonus intervention can improve the ocular hemodynamics in IOP patients.