MR对膝关节半月板撕裂诊断价值的Meta分析  

Meta-analysis of MR in diagnosis of knee meniscus tears

作　　者：张蕾[1] 董宝明[1] 孔延亮[1] 强永乾[1] 

机构地区：[1]西安交通大学第一附属医院影像科,陕西西安710061

出　　处：《中国骨与关节损伤杂志》2015年第2期172-176,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的通过Meta分析探讨MR对膝关节半月板撕裂的诊断价值及高低场强MR设备对诊断价值的影响。方法检索Medline、Web of Science、万方中文科技期刊数据库、CNKI中国知网数据库,筛选有关MR对膝关节半月板撕裂诊断的研究文献,检索时间均由建库至2013-01。采用Metadisc 1.4软件对数据进行分析,计算合并敏感度(SE)、特异度(SP)、诊断比值比(DOR)、阳性似然比(LR)、阴性LR及95%CI;异质性采用I2检验分析,绘制汇总受试者工作特征曲线(SROC),并计算曲线下面积(AUC)。采用Review Manager 5软件绘制漏斗图评价纳入文献的发表性偏倚。结果共纳入11篇文献,合计1 058例。Meta分析结果显示:MR对膝关节内侧半月板撕裂诊断的合并SE为0.87,SP为0.92,DOR为89.57,阳性LR为10.78,阴性LR为0.14,AUC为0.959 0;MR对膝关节外侧半月板撕裂诊断的合并SE为0.79,SP为0.93,DOR为50.17,阳性LR为10.18,阴性LR为0.23,AUC为0.958 9。对于低场强(<1 T)的MR,内侧半月板MR诊断的AUC为0.973 5,外侧半月板MR诊断的AUC为0.947 4;对于高场强(≥1 T)的MR,内侧半月板MR诊断的AUC为0.956 2,外侧半月板MR诊断的AUC为0.975 4。结论 MR对于膝关节半月板撕裂有较高的诊断价值,高场强和低场强的MR对半月板撕裂的诊断准确性无明显差别。Objective To investigate the diagnostic value of MR in knee meniscus tears by Meta-analysis and evaluate the influence of high and low field intensity MR equipment in the diagnostic value by Meta-analysis. Methods Search databases consisted of Medline, Web of Science, Wan-fang database of Chinese scientific and technical periodicals, CNKI. literatures about MR in the diagnosis of meniscus tear weresearched. The retrieval time ranged from time of building a database to January 2013. Meta Disc 1.4 software was used to analyze the data, calculate the pooled sensitivity（SE）, the pooled specificity（SP）, Diagnostic Odds Ratio（DOR）, positive likelihood ratio（PLR）, negative likelihood ratio（NLR） and 95% confidence interval. The I2 test was used to analyze the heterogeneity. The Summary Receiver Operating Characteristic Curve（SROC） was drawn, then the area under the curve（AUC） was calculated. The funnel plots were drawn to evaluate the literature publication bias by Review Manager 5 software. Results There were 11 literatures conforming to the standard（a total of 1 058 patients）.Meta-analysis showed： MR in knee medial meniscus tear diagnosed pooled SE was 0.87, SP was 0.92, DOR was 89.57, PLR was 10.78, NLR was 0.14, AUC was 0.959 0; MR of the knee lateral meniscus tear diagnosed pooled SE was 0.79, SP was0.93, DOR was 50.17, PLR was 10.18, NLR was 0.23, AUC was 0.958 9. For low field MR（1T）, the AUC of MR in diagnosed medial meniscus tear was 0.973 5,the AUC of MR in diagnosed lateral meniscus tear was 0.947 4. For high field MR（≥1T）, the AUC of MR in diagnosed medial meniscus tear was 0.956 2,the AUC of MR in diagnosed lateral meniscus tear was 0.975 4. Conclusion MR has high diagnostic value for meniscal tear. The field strength level takes no significant effect on the accuracy of the diagnosis of meniscal tear.

关 键 词：膝关节 半月板撕裂 磁共振 关节镜 敏感度 特异度 META分析 

分 类 号：R683.4[医药卫生—骨科学]