| Purpose: Meta analysis was used to investigate the efficacy and clinical value of magnetic rsonance elastography(MRE)in diagnosis of hepatic fibrosis,and to provide basis for clinical treatment of hepatic fibrosis.Materials and methods: 1 literatures selection:The literatures published before February 2,2017 about magnetic resonance elastography(MRE)and staging of hepatic fibrosis in Chinese or English were retrived in,the databases including WANFANG DATA,CBM ? CNKI ? VIP ? EMBASE ?PUBMED?Cochrane Library?Web of Science,and supplemented by manual retrieval for relevant literatures.The inclusion and exclusion criterias were used to select and extract the literatures data.2 The quality evaluation of literatures :we were based on the special literature quality assessment tool QUADAS-2(the Quality Assessment for Studies of Diagnostic Accuracy)to evaluate the quality of literatures,and classify the literatures into the grades of A and B.3 Extracting the required data from the literature for data processing.(1)Extracting the data in the literature to make table.(2)Testing the heterogeneity of data in every group and calculating I2 value to determine the degree of heterogeneity.I2 < 50% show heterogeneity isn't significant,I2?50% show significant heterogeneity.According to the results of heterogeneity test,the corresponding model was used to calculate the pooled statistics.(3)The sensitivity(SEN),specificity(SPE),positive likelihood ratio(+LR),negative likelihood ratio(-LR),diagnostic odds ratio(DOR)on groups of F0 VS F1-F4,F0-F1 VS F2-F4,F0-F2 VS F3-F4,F0-F3 VS F4 and heterogeneity were pooled and tested with stata 12.0 softwares respectively,SROC(receiver operating characteristic curve,),AUROC(the area under the receiver operating characteristic curve)were also implemented to evaluate the value of magnetic resonance elastography(MRE)in diagnosis of hepatic fibrosis stages.(4)The posterior probability was calculated in the study group,and assuming that the prior probability was 25%,50%,75%,calculate the posterior probability,respectively.evaluating the clinical applicability of magnetic resonance elastography(MRE)in diagnosis of stages of hepatic fibrosis by Fagan Plot analysis.(5)If the literatures heterogeneity were significant,the sources of the heterogeneity were discussed through the threshold effect and nonhreshold effect.Result: 1?Literatures selection: a preliminary search of the 1332,finally 22 are included,21 of them were in English and 1 in Chinese.2?The quality evaluation of literatures : 4 literatures in A cla ss,18 literatures in B class.3?The heterogeneities of sensitivity and specificity in F0 VS F1-F4 group,F0-F1 VS F2-F4 group,F0-F2 VS F3-F4 group,F0-F3 VS F4 group are significant.4?(1)Mixed bivariate effect model were used to combine the diagnostic statistics.F0 VS F1-F4 group: SENp,SPEp,+LRp,-LRp,DOR,AUROC were 88.8%(85.0-91.7),95.9%(91.5-98.0),21.435(10.215-44.979),0.117(0.086-0.159),183.187(72.533-462.650),0.96(0.94-0.98),respectively;F0-F1 VS F2-F4 group: SENp,SPEp,+LRp,-LRp,DOR,AU ROC were 93.3%(89.2%-35.9%),94.1%(90.2%-96.5%),15.839(9.344-26.848),0.072(0.044-0.117),221.224(100.980-484.648),0.98(0.96-0.99),respectively;F0-F2 VS F3-F4 group: SENp,SPEp,+LRp,-LRp,DOR,AU ROC were 92.9%(88.9-95.5),94.6%(91.2-96.8),17.348(10.496-28.671),0.075(0.048-0.119),230.434(111.482-476.317),0.98(0.96-0.99),respectively;F0-F3 VS F4 group: SENp,SPEp,+LRp,-LRp,DOR,AUROC were 97.7%(93.0-99.3),93.2%(90.3-95.2),14.337(9.910-20.742),0.025(0.008-0.075),580.405(144.871-2325.307),0.98(0.96-0.99),res pectively;(2)Results of Fagan plot analysis: F0 VS F1-F4 case group: the prior probability was 69.8%,the negative and positive probability of posterior probability were 21%,98%,respectively.The negative,s were 4%,10%,26%,and the positive,s were 88%,96%,98% if the prior probability were 25%,50%,75%,respectively.F0-F1 VS F2-F4 case group: the prior probability was 58.5%,the negative and positive probability of posterior probability were 9%,96%,respectively.The negative,s were 2%,7%,18%,and the positive,s were 84%,94%,98% if the prior probability were 25%,50%,75%,respectively.F0-F2 VS F3-F4 case group:the prior probability was 41.6%,the negative and positive probability of posterior probability were 1%,84%,respectively.The negative,s were 2%,7%,18%,and the positive,s were 85%,95%,98% if the prior probability were 25%,50%,75%,respectively.F0-F3 VS F4 group: the prior probability was 26.3%,the negative and positive probability of posterior probability were 1%,84%,respectively.The negative,s were 1%,2%,7%,and the positive,s were83%,93%,98% if the prior probability were 25%,50%,75%,respectively.Conclusion : MRE,as a new and noninvasive imaging method,has high diagnostic value and good clinical applicability in all stages of liver fibrosis,which can provide a reliable reference for clinical precise treatment. |
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