Meta分析比较CT、MRI及超声造影对胰腺囊性病变的诊断价值

发布时间：2018-05-18 21:02

本文选题：胰腺囊性病变 + 诊断　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:通过Meta分析比较影像学诊断方法包括CT、MRI和CEUS对胰腺囊性病变的诊断价值。方法:计算机检索Embase、Pubmed、Medline、中国生物医学文献数据库(CBM)、万方数据知识平台、相关期刊论文(CNKI)中关于以上影像学诊断方法诊断胰腺囊性病变的文献。文献筛选由两名系统评价员根据事先设定好的纳入标准和排除标准单独进行,对检索到的文献确定纳入分析的资料以及进行质量评价。采用Meta-disc软件对纳入的诊断试验结果进行分析,合并特异度、阳性似然比、敏感度、阴性似然比、诊断比值比、拟合SROC曲线并计算Q指数及曲线下面积。上述检查方法对胰腺囊性病变诊断价值的比较最后通过Q指数的Z检验进行。结果:本次meta分析共纳入文献16篇,其中包括14篇英文文献,2篇中文文献。CT诊断胰腺囊性病变的合并Sen为0.74[95%CI(0.67-0.80)],合并+LR为3.66[95%CI(1.78-7.51)],合并Spe为0.79[95%CI(0.74-0.84)],合并-LR为0.30[95%CI(0.15-0.59)],合并DOR为15.96[95%CI(5.14-49.57)],拟合SROC曲线下面积的AUC为0.8753。MRI诊断胰腺囊性病变的合并Sen为0.73[95%CI(0.65-0.80)],合并Spe为0.87[95%CI(0.81-0.92)],合并+LR为6.33[95%CI(4.00-10.03)],合并-LR为0.30[95%CI(0.22-0.39)],合并DOR为32.60[95%CI(15.04-70.68)],拟合SROC曲线下面积的AUC为0.9257。对各种影像学诊断方法的准确性进行两两比较,P值均0.05,提示差别无统计学意义。结论:Meta分析表明诊断胰腺囊性病变,MRI具有较高的特异度,但CT、MRI及超声造影诊断准确性无统计学差异。
[Abstract]:Objective: to compare the diagnostic value of CT MRI and CEUS in pancreatic cystic lesions by Meta analysis. Methods: a computerized search of Embase Pubmedmedus Medline, Chinese Biomedical Literature Database (CBMN), Wanfang data knowledge platform and CNKI (China Journal Full-text Database) was conducted for the diagnosis of pancreatic cystic lesions by the above imaging methods. Literature screening was carried out separately by two system evaluators according to the pre-set inclusion criteria and exclusion criteria. The documents retrieved were determined to include the analysis data and the quality evaluation was carried out. The Meta-disc software was used to analyze the results of the diagnostic tests. The results were combined with specificity, positive likelihood ratio, sensitivity, negative likelihood ratio, diagnostic ratio, fitting the SROC curve and calculating Q index and area under the curve. The diagnostic value of the above methods for pancreatic cystic lesions was compared by Z test of Q index. Results: a total of 16 articles were included in the meta analysis. The combined Sen of CT was 0.74 [95CIN 0.67-0.80], LR was 3.66 [95CIK 1.78-7.51], Spe was 0.79 [95CI0.74-0.84], combined LR was 0.30 [95CI0.15-0.59], combined DOR was 15.96 [95CI5.14-49.57]. The combined Sen of the lesion was 0.73 [95CII 0.65-0.80], the combined Spe was 0.87 [95CII 0.81-0.92], the combined LR was 6.33 [95CIK 4.00-10.03], the combined LR was 0.30 [95CI0.22-0.39], the combined DOR was 32.60 [95CII 15.04-70.68], the AUC fitting area under the SROC curve was 0.9257. The accuracy of various imaging diagnostic methods was compared with each other (P = 0.05), indicating that the difference was not statistically significant. Conclusion the diagnostic specificity of Mr imaging in pancreatic cystic lesions is higher than that of CT MRI and contrast-enhanced ultrasonography, but the diagnostic accuracy of CT MRI and contrast-enhanced ultrasonography is not statistically different.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R576;R445;R816.5

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