磁共振心肌负荷灌注成像诊断冠心病的Meta分析  

Diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease：a Meta-analysis

作　　者：赵静[1] 徐盼[1] 龚洪翰[1] 吴麟[1] 

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006

出　　处：《实用放射学杂志》2014年第4期593-599,共7页Journal of Practical Radiology

摘　　要：目的：用 Meta分析的方法评价磁共振心肌负荷灌注成像诊断冠心病的价值。方法检索关于磁共振心肌负荷灌注成像诊断冠心病的研究文献,结合Cochrane协作网推荐内容制定纳入标准筛选文献,采用STATA 12.0和Meta-disc 1.4软件对资料进行统计分析：包括异质性检验、发表偏倚检测、亚组分析、Meta回归、临床实用性探讨,合并汇总灵敏度（sensitivity,SEN）、特异度（specificity,SPE）、阳性似然比（positive likelihood ratio,PLR）、阴性似然比（negative likelihood ratio,NLR）、诊断比数比（diagnostic odds ratio,DOR）及95%可信区间（95%confidence interval,95%CI）；绘制汇总受试者工作特性曲线（summary receiver operating characteristic,SROC）并计算曲线下面积（area under the curve,AUC）。结果最终纳入29篇文献,汇总 SEN、SPE、PLR、NLR、DOR及95%CI分别为0.90（0.89-0.92）、0.78（0.75-0.80）、4.03（3.32-4.91）、0.14（0.11-0.18）、32.54（22.25-47.60）。绘制的 SROC曲线 AUC为0.9078。结论磁共振心肌负荷灌注成像对冠心病的诊断有较高价值,但是由于 SPE中等,导致假阳性率（误诊率）相对较高。Objective To evaluate the value of stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease.Methods Relevant literatures about stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease were searched.According to the recommended contents of the Cochrane Collaboration,we set inclusion criteria and screen literatures.Using software STATA 12.0 and Meta-disc 1.4,we analyzed the data ,including the heterogeneity,publication bias,subgroup analysis,Meta-regression,clinical application,pooled sensitivity（SEN）,specificity（SPE）,positive likelihood ratio （PLR）,negative likelihood ratio（NLR）,diagnostic odds ratio（DOR）and 95%confidence interval（95%CI）,we drew the summary receiver operating characteristic curve（SROC）and calculated the area under the curve（AUC）.Results Twenty-nine literatures were included,the pooled SEN,SPE,PLR,NLR,DOR and 95%CI were 0.90（0.89-0.92）、0.78（0.75-0.80）、4.03（3.32-4.91）、0.14 （0.11-0.18）、32.54（22.25-47.60）respectively.The AUC of SROC was 0.907 8.Conclusion The current evidence indicates that stress perfusion cardiovascular magnetic resonance has a high diagnostic accuracy for detection coronary artery disease.However, the relatively high false positive rate was found due to the medium specificity.

关 键 词：冠心病 磁共振心肌负荷灌注成像 META分析 

分 类 号：R541.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]