MRI与^(99)Tc^m-MDP骨显像对前列腺癌骨转移诊断价值的Meta分析  

Diagnostic Value of MRI versus ^(99)Tc^m-MDP Bone Scan in Osseous Metastasis of Prostate Cancer:A Meta-analysis

作　　者：沈国华[1] 周绿漪[1] 贾志云[1] 张文杰[1] 王乔[1] 邓候富[1] 

机构地区：[1]四川大学华西医院核医学科,成都610041

出　　处：《生物医学工程学杂志》2014年第4期881-887,共7页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(81171456;81271532/H1801)

摘　　要：为了评价磁共振成像(MRI)与99 Tcm-MDP骨显像对前列腺癌骨转移的诊断价值,计算机检索1990~2012年PubMed、EMBASE、EBSCO、Web of Knowledge、the Cochrane Library、Ovid等数据库,搜集关于MRI与99 TcmMDP骨显像诊断前列腺癌骨转移价值的试验,经过纳入标准和排除标准筛选后,根据QUADAS条目评估文献质量,然后提取数据和资料,采用Meta-Disc软件进行Meta分析,计算敏感性合并、特异性合并、诊断优势比合并(DOR合并),并绘制SROC曲线,计算曲线下面积(AUC)和Q*值。最终纳入5个研究,包括353个对象。Meta分析结果显示:MRI与99 Tcm-MDP骨显像诊断前列腺癌骨转移的敏感性合并分别为0.95(95%CI 0.90~0.98)与0.67(95%CI 0.58~0.75),特异性合并分别为0.97(95%CI 0.94~0.99)与0.88(95%CI 0.83~0.91),DOR合并分别为402.99(95%CI 119.05~1364.15)与23.85(95%CI 1.32~431.48);AUC与Q*分别为0.990 1、0.958 7和0.624 1、0.593 8。表明MRI诊断前列腺癌骨转移的效能优于99 Tcm-MDP骨显像。This paper is aimed to assess the diagnostic value of MRI versus 99Tc m-methylene diphosphonate （99 Tc m- MDP） bone scan （BS） for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tc m-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio （DOR）, drew the summary receiving operating characteristic （SROC） curve, and measured the area under curve （AUC） and Q＊ value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0.95 （95% CI 0.90-0. 98） and 0.67 （95% CI 0.58-0. 75）, respectively. The pooled specificity was 0.97 （95% CI 0.94-0.99） and 0. 88 （95% CI 0. 83-0. 91）, respectively. The pooled DOR was 402.99 （95- CI 119.05-1 364.15） and 23.85 （95- CI 1.32-431.48）, respectively, The AUC was 0. 990 1 and 0. 624 1, respectively. The Q＊ was 0. 958 7 and 0. 593 8. It can well he concluded that MRI is more effective than 99 Tc m MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.

关 键 词：前列腺癌 骨转移 磁共振成像 99 Tcm-MDP骨显像 META分析 

分 类 号：R737.25[医药卫生—肿瘤]