Diagnostic accuracy of early brain magnetic resonance imaging for predicting cerebral palsy in premature infants : a meta-analysis / 中华围产医学杂志

ABSTRACT

Objective To evaluate the value of early brain magnetic resonance imaging (MRI) in predicting future cerebral palsy in premature infants. Methods Searching the related literatures in PubMed,Embase,Cochrane,China Biological Medical Literature Database,China Academic Journal Full-Text Database,VIP Database and Wanfang Database.Inclusion criteria:(1) the purpose of the research was to evaluate the value of early brain MRI in predicting cerebral palsy of premature infants;(2) the type of research was prospective cohort study,randomized controlled trial,retrospective case analysis or case control studies; (3) the inspection was taken within 3 months of correction age; (4)the gold standard in diagnosing cerebral palsy was based on follow-up results,and the diagnosis criteria was clear.The sensitivity,specificity,positive and negative likelihood ratio were calculated and pooled by Stata11.0. Results Seven studies were enrolled into this meta-analysis including 772 premature infants and among which 92 were diagnosed as cerebral palsy.The pooled sensitivity was 0.93 (95％CI:0.65-0.99),specificity was 0.89 (95％CI:0.81-0.93),positive likelihood ratio was 8.19 (95％CI:4.48-14.94) and the negative likelihood ratio was 0.08 (95％CI:0.01-0.52),the area under the summary receiver operating characteristic curve was 0.95 (95％ CI:0.92-0.96).Significant heterogeneity was found (P＜0.05).When one retrospective study and one low morbidity study was removed,heterogeneity reduced significantly (P＞0.10),and predictive accuracy slightly decreased.The pooled sensitivity was 0.81 (95％CI:0.58-0.93 ),specificity was 0.82 (95％CI:0.76-0.87). Conclusions Early brain MRI has high accuracy in predicting future cerebral palsy of premature infant,especially for negative results.And for the premature infants with high risk factors,positive brain MRI result might have a higher predictive efficiency.