MRI扩散加权成像应用表观扩散系数鉴别良恶性椎体压缩骨折的Meta分析  

Differentiation of benign and malignant vertebral compression fractures by diffusion weighted imaging apparent diffusion coefficient value by Meta analysis

作　　者：孙英伟[1] 康鹏[1] 邓纯博[2] 潘诗农[3] 郭启勇[3] 

机构地区：[1]辽宁中医药大学附属医院医学影像中心,辽宁沈阳110032 [2]沈阳医学院附属中心医院骨外科,辽宁沈阳110024 [3]中国医科大学附属盛京医院放射科.辽宁沈阳110004

出　　处：《生物医学工程与临床》2016年第6期599-604,共6页Biomedical Engineering and Clinical Medicine

摘　　要：目的采用Meta分析方法评价MRI扩散加权成像(DWI)的表观扩散系数(ADC)在鉴别良恶性椎体压缩骨折的诊断价值。方法通过计算机检索2000年~2015年Cochrane图书馆、Pubmed、Ovid、Elsevier、Springer数据库、中国期刊全文数据库(CNKI),搜索关于MRI DWI中应用ADC值鉴别良恶性椎体压缩骨折的中英文文献,对符合纳入条件的原始研究进行质量评价,提取纳入研究的相关信息。采用Stata/SE 12.0软件进行统计分析。结果符合纳入标准的文献共15篇,研究病灶椎体共计804节,其中恶性椎体压缩骨折椎体424节,良性椎体压缩骨折椎体380节。应用Q检验和I2进行异质性检验,对结果进行异质性分析发现文献存在异质性,采用随机效应模型分析,恶性椎体压缩骨折的ADC值明显低于良性椎体压缩骨折[均数标准差(SMD)=-2.407,95%可信区间(CI)=-2.955^-1.860,P=0.000]。结论DWI-ADC值有助于良恶性椎体压缩骨折的鉴别。Objective To evaluate the diffusion weighted imaging（DWI） apparent diffusion coefficient（ADC） in differential di- agnosis of benign and malignant vertebral compression fractures by Meta analysis. Methods English and Chinese literature about DWI in distinguishing benign and malignant vertebral compression fractures were searched in Cochrane library, Pubmed, Ovid, Elsevier, Springer and CNKI databases from 2000 to 2015. Quality evaluation was performed for the selected literature before data extraction, and statistical analysis was performed with Stata/SE 12.0. Results Fifteen literatures with 804 vertebral compression fractures（424 malignant lesions and 380 benign lesions） were selected. By Q and I2 test, all groups had hetero- geneity, and random effects regression was developed. ADC in malignant was significantly lower than those in benign vertebral compression fractures. The standardized mean differenee（SMD） was - 2.407, 95 % confidence interval was - 2.955 - - 1.860, P = 0.000. Conclusion It is demonstrated that DWI- ADC could help to differentiate the benign vertebral compression frac- tures from the malignant.

关 键 词：良性椎体压缩骨折 恶性椎体压缩骨折 磁共振成像 磁共振扩散加权成像 表观扩散系数 META分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R683.2[医药卫生—诊断学]