Diagnostic performance of T2* gradient echo, susceptibility-weighted imaging, and quantitative susceptibility mapping for patients with multiple system atrophy-parkinsonian type: a systematic review and meta-analysis.
Eur Radiol
; 32(1): 308-318, 2022 Jan.
Article
en En
| MEDLINE
| ID: mdl-34272590
ABSTRACT
OBJECTIVES:
To investigate the diagnostic performance of T2*-weighted gradient echo (GRE) imaging, susceptibility-weighted imaging (SWI), or quantitative susceptibility mapping (QSM) in differentiating multiple system atrophy-parkinsonian type (MSA-P) from Parkinson's disease (PD).METHODS:
A systematic literature search through the MEDLINE and EMBASE databases was performed, starting on September 8, 2020, to identify studies evaluating the diagnostic performance of putaminal hypointensity on T2* GRE or SWI and phase shift on QSM in differentiating MSA-P from PD. The pooled sensitivity and specificity were obtained using hierarchical logistic regression modeling and hierarchical summary receiver operating characteristic (HSROC) modeling. The pooled diagnostic yields of T2* GRE, SWI, or QSM among MSA-P patients were calculated using the DerSimonian-Laird random-effects model.RESULTS:
Twelve original articles with 985 patients were finally included. SWI was performed in seven studies, T2* GRE was performed in three studies, and QSM was performed in two studies. The pooled sensitivity and specificity were 0.65 (95% CI 0.51-0.78) and 0.90 (95% CI 0.83-0.95), respectively. The area under the HSROC curve was 0.87 (95% CI 0.84-0.90). The Higgins I2 statistic calculations revealed considerable heterogeneity in terms of both sensitivity (I2 = 72.12%) and specificity (I2 = 70.38%). The coupled forest plot revealed the threshold effect. For the nine studies in which area under the curve (AUC) was obtainable, the AUC ranged from 0.68 to 0.947, with a median of 0.819. The pooled diagnostic yield of T2* GRE, SWI, or QSM was 66% (95% CI 51-78%).CONCLUSIONS:
Putaminal hypointensity on T2* GRE or SWI and phase shift on QSM might be a promising diagnostic tool in differentiating MSA-P from PD. Further large multicenter prospective study is warranted. KEY POINTS ⢠Three different index tests, definitions of positive image findings, thresholds, the way how to draw ROIs, reference standard, and MRI parameters could affect the heterogeneity of the study. ⢠The pooled sensitivity and specificity were 0.65 (95% CI 0.51-0.78) and 0.90 (95% CI 0.83-0.95), respectively. ⢠The pooled diagnostic yield of T2* GRE, SWI, or QSM was 66% (95% CI 51-78%).Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Atrofia de Múltiples Sistemas
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2022
Tipo del documento:
Article