3D-TOF-MRA诊断颅内动脉瘤价值的Meta分析

发布时间：2018-03-03 04:33

本文选题：三维时间飞跃法磁共振血管成像　切入点：颅内动脉瘤　出处：《临床放射学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的系统评价3D-TOF-MRA诊断颅内动脉瘤(IAN)的临床价值。方法计算机检索CNKI、EBM、VIP、Wanfang data中文数据库以及Cochrane Library、Pub Med、Embase、Web of Science外文数据库中3D-TOF-MRA诊断IAN的文献,检索时间截止至2016年9月。由两位评价员按照预先设定的纳入与排除标准独立筛选文献、提取资料,利用QUADAS-2工具评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析,计算合并敏感性(Sen)、特异性(Spe)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR),绘制受试者工作特征(SROC)曲线并计算曲线下面积(AUC)。结果最终纳入27篇文献的34个研究,共计4886例患者和2003枚可疑IAN。Meta分析结果显示,3D-TOF-MRA诊断颅内动脉瘤的Sen_(合并)=0.95[95%CI(0.93,0.97)]、Spe_(合并)=0.95[95%CI(0.92,0.97)]、+LR_(合并)=19.39[95%CI(11.51,32.67)]、-LR_(合并)=0.05[95%CI(0.03,0.08)]、DOR_(合并)=375.85[95%CI(174.87,807.83)]、AUC=0.99[95%CI(0.97,0.99)]。亚组分析结果:3D-TOF-MRA在3.0T高场强诊断IAN的敏感性高于1.5 T低场强(P0.05),研究标准和有无蛛网膜下腔出血对3D-TOF-MRA诊断IAN影响不显著(P0.05)。结论 3D-TOF-MRA对诊断颅内动脉瘤具有明确的诊断价值,高场强能提高3D-TOF-MRA诊断IAN的价值。
[Abstract]:Objective to evaluate the clinical value of 3D-TOF-MRA in the diagnosis of intracranial aneurysm (IAN). Methods the literature of 3D-TOF-MRA diagnosis of IAN in Cochrane Library Pub Medbase Web of Science was searched by computer. The retrieval time was up to September 2016. The two evaluators independently sifted the literature according to the pre-set inclusion and exclusion criteria, extracted the data, evaluated the bias risk of the inclusion study by using QUADAS-2 tools, and then analyzed Meta using Stata 12.0 software. The sensitivity, specificity, positive likelihood ratio (LRN), negative likelihood ratio (LRN), diagnostic ratio ratio (DORA), operating characteristics of subjects were drawn and the area under the curve was calculated. The results were included in 34 studies of 27 articles. A total of 4 886 patients and 3 suspicious IAN.Meta analyses showed that 3D-TOF-MRA was used to diagnose intracranial aneurysms. The Sentix (combined with 0.95 [95CII 0.930.97)] Spep (combined 0.95 [95CI0.920.97]), LR-LRV (combining 19.39 [95CI11.5132.67)] -LRS (combined with 95CI0.03 0.08)] DORSP (combined with 375.85 [95CI174.87807.83] AUC0.99 [0.97990.99]. Subgroup analysis showed that 3TOD-MRA had a higher sensitivity in diagnosing IAN at 3.0T field than in low T field (1.5 T). Subgroup analysis showed that the sensitivity of 3TOD-MRA to diagnosis of intracranial aneurysms was higher than that of T at 3.0T (95 CI 174.84.87.83)] AUC 0.99 [0.977.99]. The subgroup analysis showed that 3TOD-MRA had a higher sensitivity in the diagnosis of IAN at 3.0T than in T (1.5 T). Subgroup analysis showed that 3TOD-MRA had a higher sensitivity in diagnosing intracranial aneurysms. The study of subarachnoid hemorrhage and subarachnoid hemorrhage has no significant effect on the diagnosis of IAN by 3D-TOF-MRA. Conclusion 3D-TOF-MRA has a definite diagnostic value in the diagnosis of intracranial aneurysms. High field intensity can improve the diagnostic value of 3 D-TOF-MRA in IAN.
【作者单位】：兰州大学第一医院放射科;兰州大学第一临床学院;
【分类号】：R445.2;R743

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