Meta-Analysis
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World J Gastroenterol. Dec 7, 2013; 19(45): 8427-8434
Published online Dec 7, 2013. doi: 10.3748/wjg.v19.i45.8427
Magnetic resonance cholangiography in assessing biliary anatomy in living donors: A meta-analysis
Yu-Biao Xu, Yu-Long Bai, Zhi-Gang Min, Shan-Yu Qin
Yu-Biao Xu, Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Yu-Long Bai, Shan-Yu Qin, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Zhi-Gang Min, Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Xu YB, Bai YL and Min ZG conceived the study and implemented the final draft of the manuscript; Xu YB and Qin SY performed statistical analysis and wrote the paper; Xu YB and Bai YL searched the studies and extracted the data; all authors read and approved the final manuscript.
Correspondence to: Zhi-Gang Min, MD, Department of Radiology, the First Affliated Hospital of Xi’an Jiaotong University, Yanta Road 76, Xi’an 710061, Shaanxi Province, China. docgirl@qq.com
Telephone: +86-29-85323428 Fax: +86-29-85323428
Received: July 12, 2013
Revised: September 16, 2013
Accepted: October 17, 2013
Published online: December 7, 2013
Abstract

AIM: To establish the role of magnetic resonance cholangiography (MRC) in diagnosis of biliary anatomy in living-donor liver transplantation (LDLT) donors.

METHODS: 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.

RESULTS: 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.

CONCLUSION: Our results suggest that MRC is a high specificity but moderate sensitivity technique in diagnosis of biliary anatomy in LDLT donors.

Keywords: Magnetic resonance imaging, Cholangiography, Biliary, Anatomy, Living donors

Core tip: The current findings on the value of magnetic resonance cholangiography (MRC) in diagnosis of biliary anatomy in living-donor liver transplantation (LDLT) donors are conflicting. This meta-analysis including 12 studies with 869 patients suggested that MRC has a high specificity in diagnosis of biliary anatomy in LDLT donors, but the sensitivity is moderate. This is the first meta-analysis to investigate the diagnostic accuracy of MRC in the detection of biliary anatomy in LDLT donors; and these results will provide valuable information to the doctors when they make a decision for the living liver donors.