背景:各种MRI标记-包括中脑和脑桥区域(Marea,面积)和体积(Mvol,Pvol),比率(M/Parea,M/Pvol),和复合标记(磁共振成像帕金森病指数1,2;MRPI1,2)-已被提议作为理查森综合征(RS)和多系统萎缩-帕金森病(MSA-P)的成像标记。缺乏旨在比较这些成像标记物的诊断准确性的相关研究的系统综述/荟萃分析。
方法:搜索Pubmed和Scopus>10例患者的研究(RS,MSA-P或CBS)和>10个控件,数据在Marea上,Parea,Mvol,Pvol,M/Parea,M/Pvol,MRPI1和MRPI2。Cohen\'sd,作为效应大小的度量,对RS中的所有标记进行了计算,MSA-P,CBS。
结果:关于RS的25项研究,关于MSA-P的五项研究,并纳入了四项关于CBS的研究。中脑区域提供了区分RS与对照的最大效应大小(Cohen'sd=-3.10;p<0.001),其次是M/Parea和MRPI1。MSA-P减少了中脑和脑桥区域。纳入的研究表现出高度异质性,而发表偏倚较低。
结论:中脑区是RS的最佳MRI标记,和脑桥面积是最佳的MSA-PM/Parea和MRPI产生较小的效应大小,用于区分RS与对照。
BACKGROUND: Various MRI markers-including midbrain and pons areas (Marea, Parea) and volumes (Mvol, Pvol), ratios (M/Parea, M/Pvol), and composite markers (magnetic resonance imaging Parkinsonism Indices 1,2; MRPI 1,2)-have been proposed as imaging markers of Richardson\'s syndrome (RS) and multiple system atrophy-Parkinsonism (MSA-P). A systematic
review/meta-analysis of relevant studies aiming to compare the diagnostic accuracy of these imaging markers is lacking.
METHODS: Pubmed and Scopus were searched for studies with >10 patients (RS, MSA-P or CBS) and >10 controls with data on Marea, Parea, Mvol, Pvol, M/Parea, M/Pvol, MRPI 1, and MRPI 2. Cohen\'s d, as a measure of effect size, was calculated for all markers in RS, MSA-P, and CBS.
RESULTS: Twenty-five studies on RS, five studies on MSA-P, and four studies on CBS were included. Midbrain area provided the greatest effect size for differentiating RS from controls (Cohen\'s d = -3.10; p < 0.001), followed by M/Parea and MRPI 1. MSA-P had decreased midbrain and pontine areas. Included studies exhibited high heterogeneity, whereas publication bias was low.
CONCLUSIONS: Midbrain area is the optimal MRI marker for RS, and pons area is optimal for MSA-P. M/Parea and MRPIs produce smaller effect sizes for differentiating RS from controls.