Abstract
BackgroundThis study was performed to systematically evaluate the accuracy of magnetic resonance elastography (MRE) in staging of liver fibrosis in non-alcoholic fatty liver disease (NAFLD).MethodsPUBMED, EMBASE, Web of Science, CNKI, Cochrane Library database were searched from January 2008 to December 2018 for studies related to MRE in the diagnosis of NAFLD liver fibrosis. The quality of the included literature was assessed by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The pooled sensitivity, the pooled specificity, and area under the receiver operating characteristic curve (AUROC) value was performed by STATA 14.0 software.ResultsA total of 12 studies were included, involving 910 patients. The pooled sensitivity and specificity of each group were 0.77 (95%CI 0.69–0.83) and 0.90 (95%CI 0.83–0.94) for F ≥ 1 (mild liver fibrosis), 0.87 (95%CI 0.74–0.94) and 0.86 (95%CI 0.71–0.94) for F ≥ 2 (significant liver fibrosis), 0.89 (95%CI 0.81–0.94) and 0.84 (95%CI 0.63–0.94) for F ≥ 3(severe liver fibrosis), 0.94 (95%CI 0.85–0.98) and 0.75 (95%CI 0.35–0.94) for F ≥ 4 (early cirrhosis), respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.89, 0.93, 0.93, and 0.95, respectively.ConclusionsMRE has high accuracy in the diagnosis of hepatic fibrosis staging in patients with NAFLD.
Highlights
This study was performed to systematically evaluate the accuracy of magnetic resonance elastography (MRE) in staging of liver fibrosis in non-alcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease (NAFLD) is classified into simple fatty liver (SFL), nonalcoholic fatty hepatitis (NASH) and NAFLD-related cirrhosis, and Nonalcoholic fatty hepatitis (NASH) is a progressive form that may lead to cirrhosis or hepatocellular carcinoma (HCC) [2, 3]
In a systematic review by Singh et al that included 9 studies reporting on 232 patients [5], the pooled area under the receiver operating characteristic curve (AUROC) for MRE diagnosis of NAFLD liver fibrosis stage (F ≥ 1, F ≥ 2, F ≥ 3, F ≥ 4) was 0.86, 0.87, 0.90, and 0.91 respectively, and the values of each group are lower than that in our study
Summary
This study was performed to systematically evaluate the accuracy of magnetic resonance elastography (MRE) in staging of liver fibrosis in non-alcoholic fatty liver disease (NAFLD). NAFLD is classified into simple fatty liver (SFL), nonalcoholic fatty hepatitis (NASH) and NAFLD-related cirrhosis, and NASH is a progressive form that may lead to cirrhosis or hepatocellular carcinoma (HCC) [2, 3]. Due to that staging of fibrosis could indicate disease progression and prognosis in patients with NAFLD, and it is a critical predictors of cirrhosis, hepatocellular carcinoma, and death [4, 5]. It is critically important for accurate objective tests to detect liver fibrosis in patients with NAFLD. It is needed to develop noninvasive tests that can detect advanced fibrosis in NAFLD patients, but there still remains no noninvasive test approved to diagnose fibrosis in NAFLD patients
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