多层CT血管成像诊断中国冠心病人群中冠状动脉狭窄准确性的Meta分析  

Diagnostic performance of multidetector CT angiography for assessment of Chinese coronary artery stenosis:Meta-analysis

作　　者：蒋炳虎[1] 王继琛[1] 贾鹏[1] 李姗姗[1] 王晶晶[1] 

机构地区：[1]南京医科大学附属明基医院放射科,210019

出　　处：《中华临床医师杂志（电子版）》2011年第23期6992-6999,共8页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的运用Meta分析方法评价多层CT诊断中国冠心病人群冠状动脉狭窄的准确性。方法在主要中文数据库中,检索有关16层及16层以上CT对比冠状动脉造影诊断冠状动脉疾病价值的文章,选择适宜效应模型合并研究结果。结果共纳入112篇符合标准的文献,研究对象计7795例,血管节段计63 789段,以血管节段为基础的汇总敏感度、特异度、OR值及sROC曲线下面积分别为0.89、0.97、238.83和0.9881。结论多层CT在中国冠心病人群的冠状动脉疾病中具有很高的诊断准确性,其高度的特异性可作为冠状动脉病变的排除性诊断。Objective To review the literature on the diagnostic performance of multi-detector computed tomography angiography for assessment of symptomatic coronary artery disease in Chinese,with conventional coronary angiography as the reference standard.Methods Four chinese databases of the literature published between January 2000 and May 2011 on use of multi-detector CT angiography compared with coronary angiography in patients with symptomatic coronary artery disease were performed.Summary estimates of diagnostic odds ratio,sensitivity,specificity and sROC curve were calculated.Random-effects models were used to compare the diagnostic performance of patients,vasculars and segments units.Results 112 studies were included in the meta-analysis,and there were 63 789 segments in all.The pooled sensitivity,specificity,OR value and AUC(ROC) for detecting a greater than 50% stenosis per patient,per vascular and per segment were 0.93,0.86,78.47,0.9484;0.90,0.93,135.29,0.9725 and 0.89,0.97,238.83,0.9881,respectively.Conclusions of regression analysis indicated that the diagnostic performance significantly improved with the segment level.Conclusions The diagnostic performance of multi-detector CT for the assessment of coronary artery disease has a visible concordance with coronary angiography.

关 键 词：冠状动脉狭窄 体层摄影术 螺旋计算机 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]