DCE-MRI定量灌注参数鉴别直肠癌病理分级的Meta分析  

Effectiveness of perfusion parameters of DCE-MRI in distinguishing different histological grades of rectal cancer:a meta-analysis

作　　者：杨心悦[1] 肖晓娟[2] 卢宝兰 余深平[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]北京大学深圳医院放射科,广东深圳518036

出　　处：《中国循证医学杂志》2017年第5期536-543,共8页Chinese Journal of Evidence-based Medicine

基　　金：广东省科技计划项目(编号:2014A020212126)

摘　　要：目的系统评价动态对比增强磁共振成像(DCE-MRI)定量灌注参数K_(trans)、K_(ep)鉴别直肠癌病理分级的价值。方法计算机检索Pub Med、EMbase、Web of Science、The Cochrane Library(2017年1期)、CBM、CNKI、VIP和Wan Fang Data数据库,搜集DCE-MRI定量灌注参数K_(trans)、K_(ep)鉴别直肠癌病理分级的文献,检索时限均为1990年到2017年2月6日。由两位评价者独立筛选文献、提取资料,并采用QUADAS-2工具评价纳入研究的偏倚风险后,采用STATA 12.0软件进行Meta分析。结果共纳入11个研究,共计618名研究对象。Meta分析结果显示:低分化组与中-高分化组间K_(trans)值差异有统计学意义[SMD=1.123,95%CI(0.334,1.911),P=0.005],而两组间K_(ep)值差异无统计学意义[SMD=0.233,95%CI(–0.173,0.639),P=0.260]。结论当前证据显示,K_(trans)可用于鉴别直肠癌病理分级,而K_(ep)的临床应用价值尚需大样本原始研究进一步验证。Objective To systematically review the value of the perfusion paramenters of Ktrans and Kep of dynamic contrast enhanced MRI（DCE-MRI） in distinguishing different histological grades of rectal cancer. Methods Databases such as PubMed, EMbase, Web of Science, The Cochrane Library （Issue 1, 2017）, CBM, CNKI, WanFang Data and VIP were searched from 1990 to Feb 6th, 2017 to collect the studies according to the criteria. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies and then meta-analysis was performed by using STATA 12.0 software. Results A total of 11 studies involving 618 patients were included. The results of meta- analysis showed that there was significant difference of K between poorly differentiated grade and moderately-well differentiated grade （SMD=1.123, 95% CI 0.334 to 1.911, P=0.005）, but there was no significant difference of Kep between these two groups （SMD=0.233, 95% CI-0.173 to 0.639, P=0.260）. Conclusion Current evidence shows that K can be used to distinguish different histological grades of rectal cancer. The clinical application value of Kep still needs large sample original studies to further verify.

关 键 词：DCE-MRI 定量灌注参数 Ktrans Kep 直肠癌 META分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]