Magnetic resonance cholangiography in assessing biliary anatomy in living donors: A meta-analysis

Abstract

To establish the role of magnetic resonance cholangiography (MRC) in diagnosis of biliary anatomy in living-donor liver transplantation (LDLT) donors. A systematic review was performed by searching electronic bibliographic databases prior to March 2013. Studies with diagnostic results and fulfilled inclusion criteria were included. The methodological quality of the studies was assessed. Sensitivity, specificity and other measures of the accuracy of MRC for diagnosis of biliary anatomy in LDLT donors were summarized using a random-effects model or a fixed-effects model. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Publication bias was assessed using Deek's funnel plot asymmetry test. Sensitivity analysis was adopted to explore the potential sources of heterogeneity. Twelve studies involving 869 subjects were eligible to the analysis. The scores of Quality Assessment of Diagnostic Accuracy Studies for the included studies ranged from 11 to 14. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic OR of MRC in diagnosis of biliary anatomy in LDLT donor were 0.88 (95%CI: 0.84-0.92), 0.95 (95%CI: 0.93-0.97), 15.33 (95%CI: 10.70-21.95), 0.15 (95%CI: 0.11-0.20) and 130.77 (95%CI: 75.91-225.27), respectively. No significant heterogeneity was detected in all the above four measures. Area under SROC curve was 0.971. Little publication bias was noted across the studies (P = 0.557). Sensitivity analysis excluding a study with possible heterogeneity got a similar overall result, which suggested the little influence of this study on the overall results. Our results suggest that MRC is a high specificity but moderate sensitivity technique in diagnosis of biliary anatomy in LDLT donors.