Gd-EOB-DTPA MRI增强和Gd-EOB-DTPA MRI增强联合DWI对结直肠癌肝转移诊断价值比较的meta分析

Comparison of Gd-EOB-DTPA-enhanced MRI combined with DWI and Gd-EOB-DTPA-enhanced MRI alone in detection of colorectal cancer liver metastases: a meta analysis

目的通过荟萃(meta)分析比较单独使用钆塞酸二钠(Gd-EOB-DTPA)磁共振(MRI)增强与Gd-EOB-DTPA MRI增强联合弥散加权成像(DWI)对结直肠癌肝转移(CRCLM)的诊断价值。方法系统检索Pubmed、EMBASE、Cochrance library外文数据库及CNKI、VIP、万方等中文数据库,查找所有关于Gd-EOB-DTPA MRI增强联合DWI对比单独使用Gd-EOB-DTPA MRI增强诊断CRCLM的中英文文献。应用Stata 12.0、Revman 5.3软件进行统计分析。结果最终纳入12篇文献。单独使用Gd-EOB-DTPA MRI增强与Gd-EOB-DTPA MRI增强联合DWI诊断CRCLM的合并敏感性分别为0.92(95%CI:0.87~0.95)、0.95(95%CI:0.92~0.97),合并特异性分别为0.92(95%CI:0.85~0.96)、0.91(95%CI:0.82~0.95)。进一步对直径≤1 cm的CRCLM进行合并敏感性分析,单独使用Gd-EOB-DTPA MRI增强合并敏感性为0.70(95%CI:0.63~0.76),Gd-EOB-DTPA MRI增强联合DWI合并敏感性为0.83(95%CI:0.77~0.87),两者比较,差异有统计学意义(P<0.05)。结论与单独使用Gd-EOB-DTPA MRI增强比较,Gd-EOB-DTPA MRI增强联合DWI对直径≤1 cm的CRCLM的诊断敏感性更高。

Objective To perform a meta-analysis assessing the value of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI) combined with diffusion-weighted imaging(DWI) compared with the value of Gd-EOB-DTPA-enhanced MRI alone in detecting colorectal cancer liver metastases(CRCLM).Methods Relevant English and Chinese language studies about Gd-EOB-DTPA-enhanced MRI alone combined with DWI and Gd-EOB-DTPA-enhanced MRI alone for diagnosis of CRCLM were searched on the Pubmed, EMBASE, Cochrance library and CNKI, VIP, Wanfang and other Chinese databases. Data were calculated with software of Stata 12.0 and Revman 5.3.Results Twelve articles were included. The pooled sensitivity of Gd-EOB-DTPA-enhanced MRI alone and Gd-EOB-DTPA-enhanced MRI combined with DWI in the diagnosis of CRCLM were 0.92(95% CI: 0.87 to 0.95), 0.95(95% CI: 0.92 to 0.97), and the pooled specificity were 0.92(95% CI: 0.85 to 0.96), 0.91(95% CI: 0.82 to 0.95), respectively. The pooled sensitivity of CRCLM with diameter less than or equal to 1 cm was further analyzed. The pooled sensitivity of Gd-EOB-DTPA-enhanced MRI alone was 0.70(95% CI: 0.63 to 0.76), and that of Gd-EOB-DTPA-enhanced MRI combined with DWI was 0.83(95% CI: 0.77 to 0.87), while the difference was statistically significant(P<0.05).Conclusion Compared with Gd-EOB-DTPA-enhanced MRI alone, Gd-EOB-DTPA-enhanced MRI combined with DWI has higher diagnostic sensitivity for CRCLM with diameter less than or equal to 1 cm.