| 胡钰,方进,邓达标,邹亚妮,周全.MSCT灌注成像鉴别诊断肺结节良恶性:Meta分析[J].中国医学影像技术,2016,32(8):1226~1230 |
| MSCT灌注成像鉴别诊断肺结节良恶性:Meta分析 |
| Diagnostic value of perfusion MSCT in differentiating malignant frombenign pulmonary nodules: Meta-analysis |
| 投稿时间：2016-03-09 修订日期：2016-06-18 |
| DOI：10.13929/j.1003-3289.2016.08.020 |
| 中文关键词: 肺结节 体层摄影术,X线计算机 灌注成像 Meta分析 |
| 英文关键词:Pulmonary nodules Tomography, X-ray computed Perfusion imaging Meta-analysis |
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| 中文摘要: |
| 目的 应用Meta分析方法评价MSCT灌注成像鉴别诊断肺结节良恶性的价值。方法 检索Cochrane图书馆、Cochrane协作网、Pubmed、Web of science、中国知网及万方数据库中于2004年1月-2015年10月发表的有关CT灌注成像诊断肺结节的中英文文献，提取符合纳入标准的诊断试验数据。采用Meta disc 1.4分别汇总MSCT以不同灌注参数 诊断恶性肺结节的敏感度、特异度及95%可信区间（CI），拟合工作特征曲线（SROC）并计算曲线下面积（AUC）。结果 共纳入文献18篇，肺结节1 221个，其中恶性结节780个，良性结节441个。依次以BV、PS、BV+PS作为灌注诊断指标进行分析，其汇总敏感度分别为0.91[95% CI（0.89，0.93）]、0.88[95% CI（0.85，0.90）]、0.91[95% CI（0.88，0.93）]，汇总特异度分别为0.77[95% CI（0.73，0.81）]、0.83[95% CI（0.79，0.86）]、0.91[95% CI（0.87，0.94）]；相应AUC分别为0.92、0.93、0.97。结论 MSCT以BV、PS作为灌注诊断参数对鉴别肺结节良恶性具有较高的敏感度及特异度，当二者结合时诊断效能更高，可作为鉴别诊断的标准化灌注指标。 |
| 英文摘要: |
| Objective To investigate the evaluation of MSCT perfusion imaging in differentiating malignant from benign pulmonary nodules using Meta-analysis. Methods Chinese or English literatures about the capacity of perfusion CT in the diagnosis of pulmonary nodules in Pubmed, Cochrane collaboration, Cochrane library, Web of science, CNKI and Wanfang data-base from Jan.2004 to Oct.2015 were searched. The eligible diagnostic data was extracted from the experiment. The sensitivity and specificity of MSCT perfusion in diagnosing malignant pulmonary nodules were pooled along with 95% confidence intervals (CI) by Meta-Disc version 1.4, and the summary ROC was drawn to acquire the area beneath it. Results Totally 18 literatures with 1 221 pulmonary nodules, including 780 malignant and 441 benign nodules were gathered. Taking three indexes, blood volume (BV), permeability surface (PS) and BV combined with PS as the diagnostic parameters in differentiating malignant nodules, the pooled sensitivities and specificities were 0.91 (95% CI [0.89, 0.93]) and 0.77 (95% CI [0.73, 0.81]) for BV, 0.88 (95% CI [0.85, 0.90]) and 0.83(95% CI [0.79, 0.86]) for PS, 0.91(95% CI [0.88, 0.93]) and 0.91 (95% CI [0.87, 0.94]) for BV combined with PS. The corresponding AUC were 0.92, 0.93 and 0.97. Conclusion The sensitivity and specificity of MSCT perfusion imaging based BV and PS to identify malignant pulmonary nodules are high. Combination of PS with BV as the diagnostic parameters would be more efficient that can be used as standardized indicators in differential diagnoses. |
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