Gadoxetic acid-enhanced magnetic resonance imaging for the detection of small hepatocellular carcinoma(≤ 2.0 cm) in patients with chronic liver disease:A meta-analysis

作     者：Yan Shan Jian Gao Meng-Su Zeng Jiang Lin Peng-Ju Xu 

作者机构：Department of RadiologyZhongshan HospitalFudan UniversityShanghai Institute of Medical Imaging Center of Clinical Epidemiology and Evidence-based MedicineFudan University 

出 版 物：《World Journal of Meta-Analysis》 (世界荟萃分析杂志)

年 卷 期：2016年第4卷第4期

页      面：95-104页

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

主　　题：Liver-specifc agent Gadoxetic acid-enhanced Magnetic resonance imaging Hepatocellular carcinoma Meta-analysis 

摘      要：AIM To perform a meta-analysis assessing the value of gadoxetic acid-enhanced magnetic resonance imaging(Gd-EOB-MRI)in detecting small hepatocellular carcinoma(HCC)(≤2.0 cm)in patients with chronic liver *** Databases,including MEDLINE and EMBASE,were searched for relevant original articles published from January 2008 to February *** were extracted,and summary estimates of diagnostic accuracy indexes such as sensitivity,specificity,diagnostic odds ratio,predictive value,and areas under summary receiver operating characteristic curve were obtained using a random-effects model,with further exploration employing meta-regression and subgroup *** In 10 studies evaluating 768 patients,pooled perlesion sensitivity of Gd-EOB-DTPA was 91%(95%CI:83%-95%),with a specificity of 95%(95%CI:87%-98%).Overall positive likelihood ratio was 18.1(95%CI:6.6-49.4),for negative likelihood ratio(NLR)of 0.10(95%CI:0.05-0.19)and diagnostic odds ratio of182(95%CI:57-581).Subgroup analysis suggested that diagnostic performance of Gd-EOB-MRI for sub-centimeter HCC(≤1.0 cm)detection was low,with a sensitivity of69%(95%CI:59%-78%).In studies with both Gd-EOBMRI and diffusion-weighted imaging(DWI)performed,Gd-EOB-MRI/DWI combination was more sensitive than Gd-EOB-DTPA alone,whether for small lesions(86%vs77%)or sub-centimeter ones(80%vs 56%).CONCLUSION A limited number of small studies suggested that GdEOB-MRI has good diagnostic performance in the detection of small HCC(≤2.0 cm)among patients with chronic liver disease,but relatively lower performance for detection of sub-centimeter HCC(≤1.0 cm).Combination of Gd-EOB-MRI and DWI can improve the diagnostic sensitivity of MRI.