这项荟萃分析旨在评估多参数 MRI (mpMRI) 在检测未做过活检的男性中检测疑似前列腺癌 (PCa) 的诊断准确性。系统检索了 PubMed、Scopus 和 Cochrane 图书馆数据库，查找 2013 年 1 月至 4 月发表的研究2024 年。包含 4973 名患者的 16 项研究符合纳入标准。提取数据以构建敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV) 的 2×2 列联表。使用随机效应模型进行汇总估计，并进行亚组分析。生成汇总受试者工作特征 (SROC) 曲线以总结总体诊断性能。各项研究中 PCa 的总体检出率为 57.3%。对于检测任何 PCa，mpMRI 显示汇总敏感性为 82%（95% CI，80-83%），特异性为 62%（95% CI，60-64%），阳性似然比 (LR) 为 1.97（95%） CI，1.71-2.26），阴性 LR 为 0.28（95% CI，0.24-0.34），诊断比值比（DOR）为 7.34（95% CI，5.60-9.63），SROC 曲线下面积为 0.81。对于有临床意义的 PCa (csPCa)，mpMRI 的汇总敏感性为 88%（95% CI，87-90%），特异性为 64%（95% CI，63-66%），阳性 LR 为 2.49（95% CI） ，2.03-3.05），阴性 LR 为 0.20（95% CI，0.16-0.25），DOR 为 13.83（95% CI，9.14-20.9），曲线下面积为 0.90。这项荟萃分析表明 mpMRI 是有效的检测未进行活检的患者的 PCa，特别是 csPCa。它可以帮助减少不必要的活检并降低错过临床重要病例的风险，从而指导明智的活检决策。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

This meta-analysis aimed to assess the diagnostic accuracy of multiparametric MRI (mpMRI) in detecting suspected prostate cancer (PCa) in biopsy-naive men.PubMed, Scopus, and the Cochrane Library databases were systematically searched for studies published from January 2013 to April 2024. Sixteen studies comprising 4973 patients met the inclusion criteria. Data were extracted to construct 2×2 contingency tables for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A random-effects model was used for pooled estimation, and subgroup analyses were conducted. Summary receiver operating characteristic (SROC) curves were generated to summarize overall diagnostic performance.The overall detection rate of PCa across studies was 57.3%. For detecting any PCa, mpMRI showed pooled sensitivity of 82% (95% CI, 80-83%) and specificity of 62% (95% CI, 60-64%), with positive likelihood ratio (LR) of 1.97 (95% CI, 1.71-2.26), negative LR of 0.28 (95% CI, 0.24-0.34), and diagnostic odds ratio (DOR) of 7.34 (95% CI, 5.60-9.63), and an area under the SROC curve of 0.81. For clinically significant PCa (csPCa), mpMRI had pooled sensitivity of 88% (95% CI, 87-90%) and specificity of 64% (95% CI, 63-66%), with positive LR of 2.49 (95% CI, 2.03-3.05), negative LR of 0.20 (95% CI, 0.16-0.25), DOR of 13.83 (95% CI, 9.14-20.9), and area under the curve of 0.90.This meta-analysis suggests that mpMRI is effective in detecting PCa in biopsy-naive patients, particularly for csPCa. It can help reduce unnecessary biopsies and lower the risk of missing clinically significant cases, thereby guiding informed biopsy decisions.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.