阴性法CT胆胰管成像与磁共振胆胰管成像及MRI对胆道梗阻性疾病良恶性鉴别诊断的循证影像学研究  

Evidence-based imaging study in differential diagnosis of benign and malignant biliary obstruction with N-CTCP and MRCP+MRI

作　　者：贺丽英[1] 郭佑民[2] 钱晓军[1] 吕秀华[1] 闫玉昌[1] 

机构地区：[1]首都医科大学附属北京朝阳医院(京西院区)放射科,100043 [2]西安交通大学医学院第一附属医院影像中心

出　　处：《中华临床医师杂志（电子版）》2011年第6期1616-1622,共7页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的用Meta分析方法,比较阴性法CT胆胰管成像(N-CTCP)与磁共振胆胰管成像(MRCP)结合MRI对胆道梗阻性疾病良恶性鉴别的诊断价值。方法检索Cochrane图书馆、PubMed、OVID、Embase数据库1995～2009年公开发表的英文文献、中国期刊网1995～2009年的中文文献,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献,提取纳入研究的特征信息。统计学分析、绘制森林图和汇总受试者工作特征曲线(SROC)采用SPSS17.0及Meta-DiSc1.4软件。对两种影像学检查方法进行异质性检验,根据检验结果相对应的效应模型对所有研究进行加权定量合并,计算其汇总灵敏度、汇总特异度;分别计算两种影像学检查方法SROC曲线下面积。结果 N-CTCP与MRCP+MRI鉴别胆道良恶性梗阻的汇总灵敏度及95%可信区间分别为0.91(0.86～0.94)、0.95(0.92～0.98);汇总特异度及95%可信区间分别为0.93(0.89～0.96)、0.94(0.91～0.96)。二者的SROC曲线下面积分别为96.38%、98.00%。结论 N-CTCP与MRCP+MRI两种方法对胆道良恶性梗阻的鉴别均有很高的诊断价值,二者的汇总灵敏度、汇总特异度无统计学意义。Objective The value of differential diagnosis of bile duct obstruction diseases by N-CTCP and MRCP+MRI was assessed through evidence-based imaging.Methods Articles published from 1995 to 2009 were searched in Cochrane library,PubMed,Ovid and Embase database for relevant English-language articles and in CNKI for Chinese articles.According to the criteria for diagnostic research published by Cochrane Method Group on Screening and Diagnostic Tests,each article was critically appraised and screened.Statistical analysis was performed by SPSS 17.0 and Meta-DiSc 1.4.Heterogeneity was tested,pooled weighted sensitivity and specificity and the corresponding 95% CI were calculated.Summary receiver operating characteristic (SROC) curve was performed and the area under the curve was calculated.Results The pooled weighted sensitivity and specificity and area under SROC curve for N-CTCP to bile duct obstruction diseases was 0.91(0.86-0.94),0.93(0.89-0.96),96.38% respectively;MRCP+MRI was 0.95(0.92-0.98),0.94(0.91-0.96),98.00%,respectively.Conclusions The study of meta-analysis for N-CTCP and MRCP+MRI in the diagnosis of bile duct obstruction diseases showed that the two methods of bile duct obstruction diseases was undifferentiated.

关 键 词：胆汁淤积 胰胆管造影术 磁共振 Meta分析 ROC曲线 

分 类 号：R445.2[医药卫生—影像医学与核医学]