腺苷负荷BOLD-fMRI诊断冠心病的Meta分析  

Adenosine stress BOLD-fMRI in the diagnosis of coronary heart disease:a meta-analysis

作　　者：袁尉峰[1] 宋林声 陈祯炜 赵新湘[1] 

机构地区：[1]昆明医科大学第二附属医院放射科,昆明650101

出　　处：《放射学实践》2017年第4期395-400,共6页Radiologic Practice

基　　金：国家自然科学基金(81260213);云南省教育厅科学研究重点项目(2014Z057);云南省中青年学术技术带头人培养项目(2015HB068)

摘　　要：目的:采用Meta分析评估腺苷负荷血氧水平依赖功能磁共振(BOLD-fMRI)对冠心病的诊断价值。方法:检索2000年1月-2016年8月国内外6个数据库(Pubmed、Cochrane图书馆、Embase、CNKI中国期刊全文数据库及外文生物医学文献数据库和万方数据知识资源系统)中关于腺苷负荷BOLD-fMRI诊断冠心病的中英文文献,分别使用Cochrane协作网QUADAS-1、Review Manager 5.3QUADAS-2对纳入文献进行质量评估,采用Meta-disc version 1.4软件进行Meta分析,获得BOLD-fMRI诊断冠心病的总体敏感度(SEN)、特异度(SPE)和诊断比值比(DOR),绘制工作特征曲线(ROC),计算曲线下面积(AUC)。结果:腺苷负荷BOLD-fMRI基于心肌节段(n=1738)水平诊断冠心病的总体SEN、SPE和DOR分别为0.79(95%CI:0.75~0.83)、0.73(95%CI:0.71~0.75)和11.79(95%CI:5.78~24.08),AUC为0.8504。结论:腺苷负荷BOLD-fMRI诊断冠心病的敏感性和特异性均较高,在临床上具有广阔的应用前景。Objective：Using Meta-analysis,to assess the value of adenosine stress blood oxygen leveldependent-functional magnetic resonance imaging （BOLD-fMRI） in the diagnosis of coronary heart disease （CAD）. Methods： Six English or Chinese literature database including Pubmed,Cochrane library, Ebase, CNKI, FMJS and Wanfang database with the period from January 2000 to August 2016 were searched,concentrated on the subjects about the ability of adenosine stress BOLD- fMRI in the diagnosis of CAD. The quality of literature was assessed by QUADAS-1 of Cochrane network and QUADAS-2 of Review Manager 5.3,and Meta-Disc version 1.4 was used to perform Meta analysis. The pooled sensitivity, specificity and diagnostic odds ratios （DOR） of adenosine stress BOLD-fMRI in the diagnosis of CAD were calculated,and the summary receiver operation characteristic curve （ROC） was drawn to obtain the area under ROC （AUC）. Results：Based on myocardial segments analysis （n= 1738）, the pooled sensitivity, specificity and DOR of BOLD-MRI in the diagnosis of CAD were 0.79 （95%CI：0.75-0.83）,0.73 （95%CI：0.71-0.75） and 11.79 （95%CI：5.78-24.08） ,respectively;the value of AUC was 0. 8504. Conclusion： Adenosine stress BOLD-fMRI has high sensitivity and specificity in the diagnosis of coronary heart disease, thus has broad prospects in clinical application.

关 键 词：磁共振成像 腺苷 冠状动脉性心脏病 META分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]