增强CT和增强MRI诊断肝细胞癌经肝动脉化疗栓塞术后病灶存活或复发价值的Meta分析

李栋; 罗天杨; 冉亚伟

doi:10.3969/j.issn.1001-5256.2019.10.017

增强CT和增强MRI诊断肝细胞癌经肝动脉化疗栓塞术后病灶存活或复发价值的Meta分析

DOI: 10.3969/j.issn.1001-5256.2019.10.017

1. 白银市第一人民医院影像中心
2. 甘肃中医药大学附属第三医院

详细信息

中图分类号: R735.7;R730.44;R445.2
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出版历程
- 收稿日期: 2019-05-27
- 出版日期: 2019-10-20

Value of contrast-enhanced computed tomography and magnetic resonance imaging in diagnosis of residual or recurrent lesion after transcatheter arterial chemoembolization in hepatocellular carcinoma:A Meta-analysis

Imaging Center,The First people's Hospital of Baiyin

摘要

摘要: 目的系统评价增强CT（CECT）和增强磁共振成像（CEMRI）诊断肝细胞癌（HCC）经肝动脉化疗栓塞术（TACE）术后存活或复发病灶的临床价值。方法检索Pub Med、Embase、Cochrane Library、Web of Science、CNKI、万方数据库中CECT和（或） CEMRI诊断TACE术后存活或复发HCC病灶的研究,检索时间截止至2019年4月。由2位研究人员独立筛选文献、提取资料后,根据QUADAS-2标准评价纳入研究的偏倚风险后,采用Stata 12. 0和Revman 5. 3软件汇总分析敏感度、特异度、受试者工作特征曲线下面积（AUC）。结果共纳入13篇CECT及13篇CEMRI诊断TACE术后存活或复发HCC病灶的研究,分别包括748例患者的934个病灶和557例患者的847个病灶。CECT诊断TACE术后存活或复发HCC病灶的13项研究中存在高度异质性（P=0. 001,Q=12. 56,I2=84. 08%）; CEMRI诊断TACE术后存活或复发HCC病灶的13项研究中不存在明显异质性（P=0. 473,Q=0. 11,I2=0）。CECT诊断TA...
- 癌,肝细胞 /
- 体层摄影术,X线计算机 /
- 磁共振成像 /
- Meta分析(主题)
Abstract: Objective To systematically evaluate the value of contrast-enhanced computed tomography(CECT) and contrast-enhanced magnetic resonance imaging(CEMRI) in the diagnosis of residual or recurrent lesion after transcatheter arterial chemoembolization(TACE)in hepatocellular carcinoma(HCC). Methods Pub Med,Embase,Cochrane Library,Web of Science,CNKI,and Wanfang Data were searched for studies on CECT and/or CEMRI in the diagnosis of residual or recurrent lesion after TACE published up to April 2019. After two reviewers independently performed literature screening,data extraction,and assessment of the risk of bias using the QUADAS-2 tool,Stata 12. 0 and Rev Man 5. 3 were used to analyze pooled sensitivity,specificity,and area under the receiver operator characteristic curve(AUC). Results A total of 13 studies on CECT and 13 studies on CEMRI in the diagnosis of residual or recurrent HCC lesion after TACE were included,with 934 lesions from 748 patients and 847 lesions from 557 patients,respectively. High heterogeneity was observed in the 13 studies on CECT in the diagnosis of residual or recurrent HCC lesion after TACE(P = 0. 001,Q = 12. 56,I2= 84. 08%),while no significant heterogeneity was observed in the 13 studies on CEMRI(P = 0. 473,Q = 0. 11,I2= 0). In the diagnosis of residual or recurrent HCC lesion after TACE,CECT had a sensitivity of 72%(95% confidence interval [CI]: 66%-78%),a specificity of 99%(95% CI: 93%-100%),and an AUC of 0. 87(95% CI: 0. 83-0. 89),and CEMRI had a sensitivity of 88%(95% CI: 82%-93%),a specificity of 96%(95% CI: 91%-98%),and an AUC of 0. 98(95% CI: 0. 96-0. 99). CECT had a significantly lower sensitivity than CEMRI in the diagnosis of residual or recurrent HCC lesion after TACE(Z = 2. 12,P = 0. 03). Conclusion In comparison with CECT,CEMRI has an extremely higher diagnostic efficiency in the diagnosis of residual or recurrent HCC lesion after TACE and is thus an effective method for diagnosis.
- carcinoma,hepatocellular /
- tomography,X-Ray computed /
- magnetic resonance imaging /
- Meta-analysis as topic

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