MRI与MR关节造影诊断腕三角纤维软骨撕裂准确性的Meta分析

发布时间：2019-04-23 16:02

【摘要】：目的正确诊断腕三角纤维软骨(TFC)有无撕裂及评价撕裂程度对合理治疗至关重要,目前多采用MRI进行诊断。本文采用Meta分析评价MRI和MR关节造影(MRA)对TFC撕裂的诊断价值。资料与方法检索万方、维普数据库及CNKI等中文数据库,Cochrane图书馆、Medline、Embase及Pub Med等英文数据库,搜集符合纳入标准的文献,提取文献的一般信息,使用诊断试验准确性研究质量工具进行文献质量评价。检验文献的异质性,计算MRI及MRA诊断TFC撕裂的汇总敏感度、特异度,并绘制汇总受试者工作特征曲线。结果共获取符合纳入标准的文献15篇,其中中文2篇,英文13篇,各研究间存在异质性。MRI诊断TFC撕裂的汇总加权敏感度、特异度分别为0.66(95%CI 0.61~0.71)、0.75(95%CI 0.69~0.81),而MRA诊断TFC撕裂的汇总加权敏感度、特异度分别为0.80(95%CI 0.73~0.87)、0.86(95%CI 0.74~0.93)。MRI诊断TFC撕裂的汇总受试者工作特征曲线下面积、Q*指数分别为0.8566、0.7875,而MRA诊断TFC撕裂的汇总受试者工作特征曲线下面积、Q*指数分别为0.9123、0.8446。结论 MRA诊断TFC撕裂的准确性高于MRI,常规MRI诊断TFC撕裂不明确时,可考虑采用MRA进一步检查。
[Abstract]:Objective to correctly diagnose the carpal triangle fibrocartilage (TFC) tear and to evaluate the degree of tear is very important for reasonable treatment. At present, MRI is often used in the diagnosis of carpal triangle fibrocartilage. Meta analysis was used to evaluate the diagnostic value of MRI and MR arthrography (MRA) in the diagnosis of TFC laceration. Materials and methods Chinese databases, such as Wanfang, Vip Database and CNKI, Cochrane Library, Medline,Embase and Pub Med, were searched to collect documents that met the inclusion criteria, and to extract general information of the literatures. The diagnostic test accuracy research quality tool was used to evaluate the literature quality. To test the heterogeneity of the literature, to calculate the sensitivity and specificity of MRI and MRA in diagnosis of TFC tear, and to draw a summary of the operating characteristics of the subjects. Results A total of 15 literatures were obtained, including 2 in Chinese and 13 in English. The weighted sensitivity and specificity of MRI in diagnosing TFC tear were 0.66 (95%CI 0.61 ~ 0.71), respectively. 0.75 (95%CI 0.69, 0.81), while the aggregate weighted sensitivity and specificity of MRA in the diagnosis of TFC tear were 0.80 (95%CI 0.73, 0.87), respectively. 0.86 (95%CI 0.74? 0.93). The area under the working characteristic curve of TFC patients diagnosed by MRA was 0.8566 and 0.7875, respectively, while the area under the summary receiver operating characteristic curve of MRA diagnosis of TFC tear was 0.8566,0.7875, respectively. The Q * index was 0.9123 and 0.8446, respectively. Conclusion the accuracy of MRA in diagnosis of TFC laceration is higher than that of conventional MRI in diagnosis of TFC laceration. Further examination of MRA should be considered when the diagnosis of TFC laceration is not clear.
【作者单位】：天津市天津医院放射2科;天津市天津医院放射1科;
【分类号】：R445.2;R681.3

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