Objective To study the diagnostic value of MRI for pulmonary embolism, so as to provide information for clinical decision. Methods The trials about MRI in the diagnosis of pulmonary embolism were searched in the following databases such as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP. The data of the included trials were extracted, the methodological quality was evaluated in accordance with the quality assessment of diagnostic accuracy studies (QUADAS), and then meta-analysis was conducted using Meta-Disc 1.4 software. The weighted sensitivity and specificity were aggregated, as well as the summary receiver operating characteristic (SROC) curve. Further, the area under the curve (AUC) was calculated to evaluate the value of MRI in the diagnosis of pulmonary embolism. Results A total of 6 English articles involing 595 patients were included. The results of heterogeneity test revealed that there was statistical heterogeneity among the results of studies. According to the random effects model, the weighted sensitivity and specificity were 0.87 (95%CI 0.80 to 0.91), and 0.98 (95%CI 0.96 to 0.99), respectively; and the AUC was 0.988 7. Conclusion MRI is a better non-invasive method as a routine examination for pulmonary embolism. It shows fairly high sensitivity and specificity, and has a good clinical value.
ObjectivesTo systematically review clinical values of multi-slice spiral computed tomography angiography (MSCTA) in diagnosis of chest pain triple (CPT).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP and WanFang Data databases were searched to collect diagnostic tests on CPT diagnosed by MSCTA from inception to October 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software. The pooled weighted Sen, Spe, +LR, -LR, and the DOR were calculated, SROC and AUC were drawn.ResultsA total of 11 diagnostic studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, -LR, DOR and AUC of MSCTA for diagnosing CPT were 0.95 (95%CI 0.91 to 0.98), 0.97 (95%CI 0.94 to 0.98), 31.24 (95%CI 15.63 to 62.43), 0.05 (95%CI 0.02 to 0.10), 659.04 (95%CI 236.73 to 1 834.71) and 0.99 (95%CI 0.98 to 1.00), respectively.ConclusionsMSCTA has high sensibility and specificity for diagnosing CPT. Due to limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
ObjectiveTo summarize research progress of imaging methods in postoperative efficacy evaluating of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).MethodsThe related literatures of imaging methods in postoperative efficacy evaluating of HCC after the TACE were searched in the PubMed, Web of Science, CNKI, and Wanfang Data databases, etc. The clinical efficacy, advantages and problems of different imaging were analyzed and summarized.ResultsThe contrast-enhanced ultrasound (CEUS) had the higher value in diagnosing of residual or recurrent lesion, but the observation of the multiple or larger lesion was limited on the CEUS. The contrast-enhanced computed tomogaphy (CECT) had the lower diagnostic value for the residual or recurrent lesions as compared with the CEUS due to the artifact of iodine oil deposition. However, the CT perfusion and gemstone spectral imaging parameters could help to predict postoperative efficacy, tumor residue, and tumor recurrence after the TACE. The combination of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), functional and perfusion imaging had the better diagnostic value, and the liver function could be predicted by the DCE-MRI. The PET/CT had the excellent value in diagnosing of the residual or recurrent lesion and could be used in predicting of the patient’s survival after the TACE. The DSA was the reference standard in diagnosing of the residual or recurrent lesion after the TACE for the HCC patients, however, it had the disadvantages of invasiveness and side effect and the high operational requirements should be emphasized.ConclusionsImaging examinations including ultrasound, CT, MRI, PET/CT, and DSA are widely applied to evaluate curative effect and residual or recurrent lesion of HCC after TACE. However, principles and imaging methods of mentioned above diagnostic methods are inconsistent, as well as results of research are quite different, therefore, clinician should choose the best imaging method according to patient’s condition in diagnosis and treatment.