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Meta-Analysis
. 2018 Dec 17:2018:7457369.
doi: 10.1155/2018/7457369. eCollection 2018.

Cardiac Magnetic Resonance Imaging for Diagnosis of Cardiac Sarcoidosis: A Meta-Analysis

Jianxiong Zhang  1 , Yunxiao Li  1 , Qiufen Xu  1 , Bo Xu  1 , Haoyan Wang  1
Affiliations
Meta-Analysis

Cardiac Magnetic Resonance Imaging for Diagnosis of Cardiac Sarcoidosis: A Meta-Analysis

Jianxiong Zhang et al. Can Respir J. .

Abstract

Background: Cardiac magnetic resonance imaging (CMR) is an effective technique for the diagnosis of cardiac sarcoidosis (CS). The efficacy of CMR versus the Japanese Ministry of Health and Welfare (JMHW) guidelines considered as standard criterion for the diagnosis of CS remains to be elucidated.

Methods: In this systematic review and meta-analysis, we aimed at assessing the diagnostic accuracy of CMR in cardiac sarcoidosis. We searched on PubMed from January 1, 1980, to March 28, 2018, on Embase from January 1, 1980, to March 29, 2018, and on the Cochrane Library from January 1, 1980, to April 1, 2018, using a strategy based on the search terms (sarcoidosis and magnetic resonance imaging) independently. We analyzed the data obtained with Revman 5.3 and Stata 14.0 software.

Results: Eight studies with a total of 649 participants met the inclusion criteria, and data were extracted. CMR had an overall sensitivity of 0.93 (95% confidence interval (CI), 0.87-0.97) and specificity of 0.85 (95% CI, 0.68-0.94) for the diagnosis of cardiac sarcoidosis. The area under the summary receiver operating characteristic (SROC) curve was 0.95 (95% CI, 0.93-0.97). The subgroup analysis via public year showed that studies between 2011 and 2017 had an overall sensitivity of 0.95 (95% CI, 0.88-0.98) and specificity of 0.92 (95% CI, 0.49-0.99), with an area under the SROC curve being 0.96.

Conclusions: The results of this meta-analysis suggest that CMR could be used for the diagnosis of cardiac sarcoidosis and screening of patients suspected of CS. With the improvement of the technique, the diagnostic accuracy of MRI has improved.

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Figures

Figure 1
Figure 1
The flow of the process of identifying eligible studies.
Figure 2
Figure 2
Risk of bias of the 8 included studies.
Figure 3
Figure 3
Forest plots of sensitivity and specificity. CMR had an overall sensitivity of 0.93 (95% CI, 0.87–0.97) and specificity of 0.85 (95% CI, 0.68–0.94) in the diagnosis of cardiac sarcoidosis.
Figure 4
Figure 4
SROC curve. A random-effect SROC model was used, given the data and diagnostic-threshold variability to fit a single symmetric SROC curve. The area under the SROC curve was 0.95 (95% CI, 0.93–0.97). The overall diagnostic odds ratio was 81 (95% CI, 20–332).
Figure 5
Figure 5
The Fagan plot analysis showed the pretest probability is 50, the positive likelihood is 6, the probability of posttest is 86, the negative likelihood ratio is 0.08, and the probability of the posttest is 7.
Figure 6
Figure 6
The Deeks funnel plot asymmetry test of publication bias. The Deeks funnel plot asymmetry test of publication bias of the diagnostic odds ratios revealed publication bias existed (p < 0.00).
Figure 7
Figure 7
Forest plots of sensitivity and specificity, SROC curves, and the funnel plot asymmetry test based on the subgroup.
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