超微超顺磁性氧化铁增强MRI诊断腹盆部恶性肿瘤淋巴结转移:Meta分析  

USPIO-enhanced MRI for lymph-node metastases from abdominal and pelvic malignancies:Meta-analysis

作　　者：许露露 舒健 何国云 胡艳 蔡渝 

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000 [2]凉山彝族自治州第二人民医院放射科,四川凉山615000

出　　处：《中国医学影像技术》2018年第2期254-259,共6页Chinese Journal of Medical Imaging Technology

基　　金：四川省卫生计生委科技项目(120322);泸州市科技计划(2015LZCYD-S04)

摘　　要：目的采用Meta分析观察超微超顺磁性氧化铁(USPIO)增强MRI诊断腹盆部恶性肿瘤淋巴结转移的价值。方法检索PubMed、Embase、Cochrane Library、万方、维普及CNKI数据库,按照纳入及排除标准筛选文献,并提取四格表数据。采用Meta Disc 1.4及STATA 11.0软件检验异质性并进行统计学分析,选择相应效应模型,合并其效应量(敏感度、特异度),绘制综合受试者工作特征曲线并计算曲线下面积(AUC)。结果共纳入20篇英文文献,1 211例患者,3 583个淋巴结。USPIO增强MRI诊断腹盆部恶性肿瘤淋巴结转移汇总敏感度、特异度分别为0.89[95%CI(0.86,0.91)]、0.96[95%CI(0.95,0.96)],AUC为0.98。回归分析显示异质性可能来源于肿瘤部位;亚组分析显示USPIO增强MRI诊断腹腔肿瘤淋巴结转移敏感度更高。结论 USPIO增强MRI对腹盆部恶性肿瘤淋巴结转移有较高诊断效能。Objective To investigate value of ultrasmall superparamagnetic iron oxide （USPIO）-enhanced MRI in diagnosis of lymph node metastasis from abdominal and pelvic malignancies with Meta-analysis. Methods A systematic search was conducted in PubMed, Embase, Cochrane Library, Wanfang, VIP and CNKI databases. The literature were screened according to inclusion and exclusion criteria, and four tabular data were extracted. With Meta Disc version 1.4 and STATA 11.0 software, statistical analysis was performed and heterogeneity of the included articles was tested. Based on the result of heterogeneity test, proper effect model was selected to calculate the pooled sensitivity and specificity. Summary receiver operating characteristics curve was obtained, and the area under curve （AUC） was calculated. Results Totally 20 English literature were enrolled, including 1 211 patients and 3 583 lymph nodes. The pooled sensitivity and specificity for USPIO-enhanced MRI in diagnosis of lymph node metastasis was 0.89 （95%C1 [0.86,0.91） and 0.96 （95 %CI [0.95, 0.96]）, and AUC was 0.98, respectively. Regression analysis revealed that the heterogeneity may result from the location of tumors, and subgroup analysis showed that pooled sensitivity in diagnosis of lymph node metastasis in abdominal malignancies was good. Conclusion USPIO-enhanced MRI has good diagnostic efficacy in diagnosis of lymph node metastasis from abdominal and pelvic malignancies.

关 键 词：超顺磁性氧化铁增强 肿瘤淋巴结转移 META分析 MRI诊断 腹盆部 恶性 超微 COCHRANE 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.4[医药卫生—诊断学]