已发表论文

电脑断层扫描与磁共振成像诊断颈部淋巴结转移癌:系统回顾和汇总分析

 

Authors Sun J, Li B, Li CJ, Li Y, Su F, Gao QH, Wu FL, Yu T, Wu L, Li LJ

Published Date June 2015 Volume 2015:8 Pages 1291—1313

DOI http://dx.doi.org/10.2147/OTT.S73924

Received 8 September 2014, Accepted 22 October 2014, Published 8 June 2015

Approved for publication by Dr Faris Farassati

Abstract: Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87]) than MRI (0.72 [95% CI 0.70–0.74]) when node was considered as unit of analysis (<0.05); MRI had a higher SPE (0.81 [95% CI 0.80–0.82]) than CT (0.72 [95% CI 0.69–0.74]) when neck level was considered as unit of analysis (<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively.
Keywords: computed tomography, magnetic resonance imaging, metastasis, head and neck cancer, meta-analysis