| 张少娟,郭佑民,李洪伦,金晨望,杨健,张毅力.CTPA与V/Q扫描诊断肺栓塞的比较研究[J].中国医学影像技术,2004,20(3):414~418 |
| CTPA与V/Q扫描诊断肺栓塞的比较研究 |
| CTPA versus ventilation-perfusion scan in diagnosing pulmonary embolism |
| |
| DOI： |
| 中文关键词: 肺栓塞 体层摄影术,X线计算机 V/Q扫描 动脉造影 Meta分析 SROC |
| 英文关键词:Pulmonary embolism Tomography,X-ray computed Ventilation-perfusion scan Angiography Meta analysis SROC |
| 基金项目: |
|
| 摘要点击次数: 3089 |
| 全文下载次数: 1402 |
| 中文摘要: |
| 目的 以肺动脉造影为金标准,评价CT血管造影(CTPA)和肺通气灌注扫描(V/Q扫描)对肺栓塞的临床诊断价值。方法 检索Cochrane图书馆、PubMed、Ovid数据库和中国期刊网中关于CTPA诊断肺栓塞的中英文文献,按照Cochrane协作网推荐的诊断试验的纳入标准筛选文献,提取纳入研究的特征信息。将入选研究和一项多中心的V/Q扫描的研究结果进行加权定量合并,计算汇总灵敏度和特异度及其95%可信区间,绘制汇总受试者工作特征曲线(SROC),计算曲线下面积。评价两种检查方法与肺动脉造影结果的一致性。结果 8篇评价CTPA的文献符合纳入标准。CTPA的汇总灵敏度和特异度分别为0.86和0.90,V/Q扫描的汇总灵敏度和特异度为0.82和0.60。二者的SROC曲线下面积(%)分别为94.43和81.90。CTPA与金标准肺动脉造影的诊断结果一致性较高。结论 CTPA诊断PE在准确性和确定性方面较V/Q扫描的价值高。鉴于CTPA的无创性及其与肺动脉造影结果的一致性,CTPA可作为肺动脉造影不能使用时的首选检查方法。 |
| 英文摘要: |
| Purpose To assess the overall diagnostic value of different imaging methods involving computed tomography pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scan with the gold standard of pulmonary angiography in diagnosing pulmonary embolism (PE). Methods A search in Cochrane Library, PubMed, Ovid, and CNKI (China National Knowledge Infrastructure) was performed to identify relevant English and Chinese articles from 1990 to 2003. Criteria for inclusion were established based on criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Subsequently, the characteristics of the included articles were appraised and extracted, which were statistically compared to the published results of a multi-center study of V/Q scan in the diagnosis of pulmonary embolism (PIOPED). Proper effect model was selected to calculate pooled weighted values of sensitivity and specificity and the corresponding 95%CI. Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally, the agreement between these two methods and pulmonary angiography was analyzed. Results Eight articles were retrieved for the group of CTPA. The pooled weighted sensitivity and specificity for CTPA and V/Q scanning were 0.86/0.90 and 0.82/0.60, and the AUC of SROC (%) for the two methods were 94.43 and 81.90, respectively. Furthermore, significant agreement was found between CTPA and pulmonary angiography. Conclusion CTPA was superior to V/Q scanning in the diagnosis of PE. Furthermore, with both the agreement with pulmonary angiography and noninvasive characteristics, CTPA may be considered to be a preference diagnostic method when pulmonary angiography is not applicable. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
