Objectives The aim of this study was to determine the diagnostic accuracy of contrast-enhanced magnetic resonance imaging (CE-MRI) for the detection of perineural spread (PNS) in head and neck cancer patients. Methods A systematic review of PubMed, Embase, Scopus, Web of Science and Cochrane Library databases was performed up to May 20, 2022. We included diagnostic accuracy studies that used CE-MRI for the diagnosis of PNS in patients with head and neck cancer, using histopathology from surgical specimens as the reference standard. Potential bias and applicability of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADUS-2) tool. Pooled joint effect sizes of sensitivity and specificity were calculated by applying bivariate random-effects meta-analysis model. Results Nine studies with 259 patients were included. The pooled sensitivity and specificity of CE-MRI for detecting PNS were 89% (95% confidence interval [CI]: 73–96) and 83% (95% CI: 73–90), respectively. Stratifying by MRI strength, 1.5 T had a higher sensitivity of 97% (95% CI: 47–100) compared with 3 T, which had a sensitivity of 83% (95% CI: 72–90). Both 1.5- and 3-T MRI had a similar specificity in detecting PNS of 85% (95% CI: 63–95) and 84% (95% CI: 75–91), respectively. Conclusions CE-MRI provides good diagnostic test accuracy for the detection of PNS in head and neck cancer. Current evidence suggests 1.5-T MRI provides greater sensitivity compared with 3-T MRI.

中文翻译：

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对比增强 MRI 检测头颈癌神经周围扩散的诊断准确性：系统回顾和荟萃分析

目的 本研究的目的是确定对比增强磁共振成像 (CE-MRI) 用于检测头颈癌患者神经周围扩散 (PNS) 的诊断准确性。方法 对截至 2022 年 5 月 20 日的 PubMed、Embase、Scopus、Web of Science 和 Cochrane 图书馆数据库进行系统回顾。我们纳入了使用 CE-MRI 诊断头颈癌患者 PNS 的诊断准确性研究，使用手术标本的组织病理学作为参考标准。使用诊断准确性研究质量评估 2 (QUADUS-2) 工具评估纳入研究的潜在偏倚和适用性。通过应用双变量随机效应荟萃分析模型计算敏感性和特异性的合并联合效应大小。结果 纳入 9 项研究，涉及 259 名患者。CE-MRI 检测 PNS 的汇总敏感性和特异性分别为 89%（95% 置信区间 [CI]：73-96）和 83%（95% CI：73-90）。按 MRI 强度分层，1.5 T 的敏感性更高，为 97%（95% CI：47-100），而 3 T 的敏感性为 83%（95% CI：72-90）。1.5-T MRI 和 3-T MRI 在检测 PNS 方面具有相似的特异性，分别为 85%（95% CI：63-95）和 84%（95% CI：75-91）。结论 CE-MRI 为头颈癌 PNS 检测提供了良好的诊断测试准确性。目前的证据表明，与 3-T MRI 相比，1.5-T MRI 具有更高的灵敏度。