背景:铁敏感性脑MRI上的背外侧黑质高强度(DNH)丢失对帕金森病的检测很有用。DNH丢失也可能在路易体痴呆(DLB)中具有诊断价值,a-突触核蛋白相关病理。我们的目标是定量综合证据,研究MRI的作用,一线成像模式,在早期DLB检测和与其他痴呆的鉴别中。
方法:我们的研究是根据PRISMA声明进行的。MEDLINE,Scopus,WebofScience,和Cochrane图书馆使用诸如“路易体痴呆症”之类的术语进行搜索“背外侧黑质高强度”,和“MRI”。仅包括英文撰写的同行评审的诊断准确性研究。我们使用QUADAS-2进行质量评估。
结果:我们的搜索产生了363个搜索结果。三项研究符合资格,一切都令人满意,高质量。227例患者的总人口包括63例DLB和164例其他疾病(阿尔茨海默病,额颞叶痴呆,轻度认知障碍)。使用单变量随机效应逻辑回归模型,我们的荟萃分析导致了集合敏感性,特异性和DOR为0.82[0.62;0.92],0.79[0.70;0.86]和16.26([3.3276;79.4702],p=0.0006),分别,扫描与混合场强(1.5和3T)。3T扫描的亚组分析显示合并敏感性,特异性和DOR为0.82[0.61;0.93],0.82[0.72;0.89]和18.36([4.24;79.46],p<0.0001),分别。
结论:铁敏感MRI上的DNH丢失可能是DLB检测的支持性生物标志物,这可能会增加DLB诊断标准的价值。需要使用标准化协议进行进一步评估,以及与其他支持性和指示性生物标志物的直接比较。
BACKGROUND: Loss of dorsolateral nigral hyperintensity (DNH) on iron-sensitive brain MRI is useful for Parkinson\'s disease detection. DNH loss could also be of diagnostic value in dementia with Lewy bodies (DLB), an a-synuclein-related pathology. We aim to quantitatively synthesize evidence, investigating the role of MRI, a first-line imaging modality, in early DLB detection and differentiation from other dementias.
METHODS: Our study was conducted according to the PRISMA statement. MEDLINE, Scopus, Web of Science, and Cochrane Library were searched using the terms like \"dementia with Lewy bodies\", \"dorsolateral nigral hyperintensity\", and \"MRI\". Only English-written peer-reviewed diagnostic accuracy studies were included. We used QUADAS-2 for quality assessment.
RESULTS: Our search yielded 363 search results. Three studies were eligible, all with satisfying, high quality. The total population of 227 patients included 63 with DLB and 164 with other diseases (Alzheimer disease, frontotemporal dementia, mild cognitive impairment). Using a univariate random-effects logistic regression model, our meta-analysis resulted in pooled sensitivity, specificity and DOR of 0.82 [0.62; 0.92], 0.79 [0.70; 0.86] and 16.26 ([3.3276; 79.4702], p = 0.0006), respectively, for scans with mixed field strength (1.5 and 3 T). Subgroup analysis of 3 T scans showed pooled sensitivity, specificity and DOR of 0.82 [0.61; 0.93], 0.82 [0.72; 0.89] and 18.36 ([4.24; 79.46], p < 0.0001), respectively.
CONCLUSIONS: DNH loss on iron-sensitive MRI might comprise a supportive biomarker for DLB detection, that could augment the value of the DLB diagnostic criteria. Further evaluation using standardized protocols is needed, as well as direct comparison to other supportive and indicative biomarkers.