Comparison of magnetic resonance elastography and transient elastography in the diagnosis of hepatic fibrosis: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Few studies comprehensively compared the performance of magnetic resonance elastography (MRE) and transient elastography (TE) in the diagnosis of liver fibrosis. Therefore, we conducted a meta-analysis to evaluate and compare the diagnostic efficacy of these 2 techniques in patients with hepatic fibrosis in order to gain a better understanding of their overall diagnostic performance and aid in maximizing their clinical utility. METHODS: Systematic literature searches of the PubMed, EmBase, Cocharane Library, and China National Knowledge Infrastructure databases were carried out to identify studies that applied MRE and TE in the diagnosis of liver fibrosis. The combined sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (ORs) were estimated using a bivariate random effects model. Review Manager 5.2 was used to analyze the selected articles, and forest plot, sensitivity, and bias analyses were performed for the included literature. To determine the diagnostic efficacy of MRE and TE for liver fibrosis, pooled sensitivity and specificity analyses were conducted. RESULTS: Eight studies met the inclusion criteria. In the diagnosis of stage F0-F1 liver fibrosis, MRE showed higher sensitivity than TE (OR =0.62, 95% CI 0.41-0.95, P=0.03). MRE also showed higher specificity than TE for diagnosing stage F2-F4 liver fibrosis (OR =0.41, 95% CI 0.27-0.62, P<0.0001). There was no difference in the sensitivity of MRE and Te to F2-F4 hepatic fibrosis and the specificity of MRE and Te to F0-F1 hepatic fibrosis. CONCLUSIONS: In terms of sensitivity and specificity, MRE is superior to TE in diagnosing different stages of liver fibrosis to a certain extent. MRE may be a useful, noninvasive method for the assessment of liver fibrosis in patients with chronic liver disease.