A systematic review and meta-analysis of magnetic resonance and computed tomography enterography in the diagnosis of small intestinal tumors

Abstract

Objective To explore the potential value of magnetic resonance (MR) and computed tomography (CT) enterography in the diagnosis of small intestinal tumor (SIT). Methods Articles reporting on the diagnosis of SIT by MR and CT enterography deposited in Chinese and foreign literature databases were identified and evaluated using the quality assessment of diagnostic accuracy studies (QUADAS). The diagnostic data extracted from the articles were adopted for meta-analysis using Meta-disc 1.40 software. Analysis was undertaken to compare the sensitivity, specificity, positive and negative likelihood ratios, and the diagnostic odds ratio (DOR) of MR and CT enterography in the diagnosis of SIT. The diagnostic values of the two imaging methods were analyzed by summary receiver operating characteristic (SROC) curves. The meta-analysis was registered at INPLASY (202380053). Results A total of eight articles, including 551 cases of SIT were included in this analysis. The pooled sensitivity and specificity of MR enterography were 0.92 (95% CI [0.89–0.95]) and 0.81 (95% CI [0.74–0.86]), respectively, whilst CT enterography had a sensitivity of 0.93 (95% CI [0.90–0.95]) and a specificity of 0.83 (95% CI [0.76–0.88]). For MR enterography, the combined positive likelihood ratio was 4.90 (95% CI [3.50–6.70]), the combined negative likelihood ratio was 0.10 (95% CI [0.07–0.14]), and the area under the receiver operating characteristic curve (AUROC) was 0.940. For CT enterography, the corresponding values were 5.40 (95% CI [3.90–7.40]), 0.08 (95% CI [0.06–0.12]), and 0.950, respectively. When the pretest probability for MR was assumed to be 50%, the posterior probabilities for positive and negative results were calculated as 83% and 9%, respectively. For CT enterography with a pretest probability of 50%, the posterior probabilities of positive and negative results were 84% and 8%, respectively. Conclusion MR and CT enterography have high accuracy in the diagnosis of SIT and have a valuable role in the diagnosis and management of these tumors.

Endoscopic Diagnosis of Small Bowel Tumor

“…CT enterography, in which a bowel cleansing medium such as polyethylene glycol is taken as a negative contrast agent before the CT scan, provides detailed imaging of the small bowel by adequate lumen distention and provides information on masses, wall thickening, and narrowing of the small bowel. According to a meta-analysis, the sensitivity and specificity of CT enterography for small bowel tumors were 0.93 and 0.83, respectively [18]. Although there are problems with radiation exposure and side effects from contrast media, it is a minimally invasive test that provides a large amount of information quickly.…”

“…Although there are problems with radiation exposure and side effects from contrast media, it is a minimally invasive test that provides a large amount of information quickly. Magnetic resonance enterography has similar sensitivity and specificity [18] and can be an alternative with no radiation exposure when it is available.…”