Comparison of magnetic resonance imaging and computed tomography in the diagnosis of acute pancreatitis: a systematic review and meta-analysis of diagnostic test accuracy studies

BACKGROUND: Acute pancreatitis (AP) is characterized by acute onset, rapid development, and poor prognosis. Timely diagnosis and identification of the cause are the key to formulating the clinical program and improving the prognosis. There were several studies on this topic but the results varied. This study systematically evaluated and analyzed reports on the comparison of magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of AP in recent years, providing evidence for clinical diagnosis and treatment. METHODS: The databases of PubMed, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched for literature on MRI and CT in the diagnosis of AP. After evaluating the articles and extracting the data, the software RevMan 5.4 and Stata 16.0 were used for meta-analysis. RESULTS: A total of 9 articles were included in the selection, with a total of 566 patients having undergone diagnosis. Meta-analysis showed that for MRI, the diagnostic sensitivity was 92%, 95% confidence interval (CI): 85% to 96%; specificity was 74%, 95% CI: 50% to 89%; positive likelihood ratio was 3.5, 95% CI: 1.6 to 8.0; negative likelihood ratio was 0.11, 95% CI: 0.05 to 0.24; diagnostic odds ratio (DOR) was 32, 95% CI: 7 to 136; and the area under the curve (AUC) value was 0.93, 95% CI: 0.90 to 0.95. For CT, the diagnostic sensitivity was 73%, 95% CI: 55% to 85%; specificity was 64%, 95% CI: 42% to 82%; positive likelihood ratio was 2.0, 95% CI: 1.1 to 3.6; negative likelihood ratio was 0.43, 95% CI: 0.24 to 0.76; DOR was 5, 95% CI: 2 to 14; and the AUC value was 0.74, 95% CI: 0.70 to 0.78. The AUC value of MRI was significantly greater than CT (Z=3.684, P=0.023). DISCUSSION: In the diagnosis of AP, MRI is more sensitive, specific, and accurate than CT, and can be used as the first choice for the diagnosis of AP.