| 李航,龚晓明,邓明,汪明月,鲁植艳.平衡式稳态自由进动序列MRA诊断肾动脉狭窄:Meta分析[J].中国介入影像与治疗学,2019,16(1):46-51 |
| 平衡式稳态自由进动序列MRA诊断肾动脉狭窄:Meta分析 |
| Balanced steady-state free precession MRA for diagnosing renal artery stenosis: Meta-analysis |
| 投稿时间：2018-08-28 修订日期：2018-10-30 |
| DOI：10.13929/j.1672-8475.201808038 |
| 中文关键词: 肾动脉梗阻 平衡式稳态自由进动 对比剂 磁共振成像 血管造影术 综合分析 |
| 英文关键词:renal artery obstruction balanced steady-state free precession contrast media magnetic resonance imaging angiography meta-analysis |
| 基金项目:北京市医院管理局重点医学专业发展计划（ZYLX201511）。 |
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| 中文摘要: |
| 目的 采用Meta分析方法评价平衡式稳态自由进动序列（B-SSFP）MRA对肾动脉狭窄（RAS）的诊断价值。方法 计算机检索PubMed、EMabase、Cochrane Library数据库中关于B-SSFP诊断RAS的英文文献。以诊断准确性研究质量评价工具-2评价文献质量。采用Meta Disc 1.4和Stata 12.0统计分析软件，绘制汇总受试者工作特征（SROC）曲线，并计算AUC及合并敏感度、特异度、诊断比值比。结果 最终纳入的12篇文献21组数据存在高度异质性，采用随机效应模型。Meta分析结果显示，B-SSFP诊断RAS的合并敏感度、特异度分别为0.85[95% CI（0.81，0.88），I2=56.8%]和0.96[95% CI（0.95，0.97），I2=85.3%]，合并SROC曲线的AUC为0.964 4，合并诊断比值比为137.94[95% CI（84.75，224.50）]。回归分析结果显示异质性可能来源于发表年（P=0.038）。结论 B-SSFP对RAS诊断具有较高敏感度和特异度，有望成为肾功能不全患者的首选检查方法。 |
| 英文摘要: |
| Objective To investigate the value of balanced steady-state free precession (B-SSFP) MRA for diagnosing renal artery stenosis (RAS) with Meta-analysis. Methods PubMed, EMbase and Cochrane Library databases were searched. English studies assessed B-SSFP MRA diagnostic performance in RAS patients were reviewed. Quality assessment was conducted by adopting the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. Statistical analysis was adopted using the software of Meta Disc 1.4 and Stata 12.0. The summary ROC (SROC) curve was drawn, and pooled AUC, sensitivity, specificity, diagnostic odds ratio were calculated. Results A total of 12 articles including 21 results were enrolled, which had highly heterogeneous by using random effects models. In B-SSFP diagnosing RAS, meta-analysis showed the pooled sensitivity was 0.85 (95%CI[0.81, 0.88], I2=56.8%) and pooled specificity was 0.96 (95% CI[0.95, 0.97], I2=85.3%), the area under the SROC curve was 0.964 4, the pooled diagnostic odds ratio was 137.94 (95%CI[84.75, 224.50]). Regression analysis showed that heterogeneity may be derived from the year of publication (P=0.038). Conclusion B-SSFP MRA is accurate and reliable for diagnosing RAS, and may be the first choice in patients with renal insufficiency. |
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