DWI与DCE-MRI联合应用对乳腺良恶性病变鉴别诊断价值的Meta分析  

Analysis of diffusion-weighted imaging combined with dynamic contrast-enhanced MR imaging in the differential diagnosis of benign and malignant breast lesions on Meta-analysis

作　　者：贺丽英[1] 潘克梫[1] 郭佑民[2] 

机构地区：[1]清华大学医院放射科,北京100084 [2]西安交通大学第一附属医院影像科

出　　处：《实用放射学杂志》2016年第11期1696-1701,共6页Journal of Practical Radiology

摘　　要：目的运用Meta分析方法研究近几年在最新技术条件下扩散加权成像（DWI）与动态对比增强磁共振成像（DCE-MRI）联合应用对乳腺良恶性病变的鉴别诊断价值。方法检索PubMed、EMbase、Web of Science、Cochrane图书馆、中国期刊网（CNKI）的英文和中文文献，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。文献评价采用诊断研究评价工具QUADAS-2。数据分析采用Meta-DiScl．4软件，检验异质性，并根据异质性结果选择相应的效应模型。对所有研究进行加权定量合并，计算汇总灵敏度（Se）、汇总特异度（Sp）。绘制汇总受试者工作特征曲线（SROC），并计算曲线下面积（AUC）。结果纳入28项研究，共1707例患者、1857个病灶。28项研究存在异质性，按照随机效应模型计算汇总Se、汇总Sp分别为93％、88％，SROC的AUC为0．96。结论DWI与DCE-MRI联合应用对乳腺良恶性病变的鉴别诊断具有很高的灵敏度和特异度，是一种诊断效能较高的检查方法。Objective To determine the diagnostic performance of diffusion-weighted imaging （DWI） combined with dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） in the differential diagnosis of benign and malignant breast lesions on Meta-analysis. Methods A comprehensive search of the PubMed, EMbase, Web of Science, Cochrane Library databases and CNKI was performed to identify relevant English and Chinese language articles. Criteria for inclusion were established, which based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Methodological quality was assessed by using the quality assessment of diagnostic studies （QUADAS-2） instrument. Subsequently, the characteristics of the included articles were appraised and extracted. Statistical analysis was performed by employing Meta-DiScl. 4 software pro- grams. Heterogeneity of the included articles was tested, which was used to select proper effect model to calculate pooled weighted sensitivity and specificity. Summary receiver operating characteristics （SROC） curve was performed and the area under the curve （AUC） was calculated. Results 28 studies were analyzed, which included a total of 1 707 patients with 1 857 breast lesions. The pooled sensitivity and specificity of DWI combined with DCE-MRI were 93% and 88%, respectively. The area under the SROC curve （AUC-SROC） was 0.96. Conclusion DWI combined with DCE-MRI has a highly accurate sensitivity and specificity with a strong ROC curve in the differential diagnosis of benign and malignant breast lesions.

关 键 词：乳腺病变 动态对比增强磁共振成像 META分析 

分 类 号：R655.8[医药卫生—外科学] R445.2[医药卫生—临床医学]