DWI联合DCE-MRI及高频彩超在判定乳腺占位良恶性中的Meta分析  

Meta-analysis of DWI with DCE-MRI and HFCDU in judging benign and malignant breast occupancy

作　　者：杜惠军 王晓燕[1,2] 丁晓燕[1,2] 鲁辛健 班允清 DU Hui-jun;WANG Xiao-yan;DING Xiao-yan(The Fifth Clinic Medical College,Xinjiang Medical University,CT/MR Room,The Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第五临床医学院,新疆乌鲁木齐830000 [2]新疆医科大学第五附属医院CT MR室,新疆乌鲁木齐830000

出　　处：《中国医学装备》2020年第4期42-47,共6页China Medical Equipment

摘　　要：目的:对弥散加权成像(DWI)联合动态增强扫描-MRI(DCE-MRI)及高频彩超在乳腺占位良、恶性判定中的准确性及效能进行Meta分析。方法:通过检索中国知网、万方、维普、中文科技期刊全文数据库、中国生物医学文献等数据库,其中检索29篇关于DWI联合DCE-MRI以及高频彩超在女性乳腺占位的中文文献,筛选相应文献采集相关指标。通过Meta-disc1.4软件行数据分析,合并敏感度及特异度并绘制综合受试者工作特征曲线(SROC),并通过SROC曲线下面积(AUC)及其Q*指数比较两种检查的诊断价值,并用Stata软件中偏倚检验法Egger法和Begg法对文献发表偏倚进行检验。结果:在符合入选标准的29篇文献中,诊断方式为DWI联合DCE-MRI的入选16篇,以高频彩超为诊断方式的入选13篇。DWI联合DCE-MRI及高频彩超的灵敏度和95%置信区间(95%CI)分别为0.92和0.89~0.94及0.80和0.77~0.83;特异度和95%CI分别为0.86和0.83~0.90及0.85和0.83~0.87;AUC分别为94.74%和89.53%;Q*指数分别为0.8870和0.8263。结论:DWI联合DCE-MRI及高频彩超均可广泛应用于临床,DWI联合DCE-MRI对病灶良恶性诊断的灵敏度较高,特异度与高频彩超差别不大,相比二者对乳腺良恶性判断的诊断效能,DWI联合DCE-MRI略优于高频彩超。Objective: To implement Meta-analysis for the accuracies and efficiencies of diffusion weighted imaging(DWI) combined with dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI) and high-frequency color Doppler ultrasonography(HFCDU) in judging benign and malignant breast occupancy. Methods: 29 Chinese literatures that DWI combined with DCE-MRI and HFCDU for breast occupancy of female were obtained through China national knowledge infrastructure(CNKI), Wanfang, Weipu, full-text database of Chinese scientific and technological journals and Chinese biomedical literature database. And corresponding literatures were screened and relevant indicators were collected. Meta-disc1.4 software was used to analyze these data, and to combine the sensitivity and specificity, and to draw the summary receiver operating characteristics(SROC) curve. The diagnostic values of the two kinds of tests were compared by area under curve(AUC) of SROC curve and Q* index, and the bias of literature publication was tested by Egger method and Begg method of bias test method in Stata software. Results: In the 29 literatures met the inclusion criteria, diagnostic mode of 16 literatures was DWI combined with DCE-MRI and that of 13 literatures was HFCDU. The sensitivities and confidence intervals of DWI combined with DCE-MRI and HFCDU were 0.92(95% CI: 0.89-0.94) and 0.80(95% CI: 0.77-0.83), respectively. And specificity and 95% confidence intervals of them were 0.86(95% CI: 0.83-0.90) and 0.85(95% CI: 0.83-0.87), respectively. And the AUC of two methods were 94.74% and 89.53%, and Q* index of two methods were 0.8870 and 0.8263, respectively. Conclusion: Both DWI combined with DCE-MRI and HFCDU can be widely used in clinic. And DWI combines with DCE-MRI has higher sensitivity in the diagnosis of benign and malignant lesions, and its specificity is not significantly different with HFCDU. In the comparison of the diagnostic efficiency of two methods in judging benign and malignant breast occupancy, DWI combines with DCE-MRI is slightly superi

关 键 词：乳腺占位性病变 弥散加权成像(DWI) 动态增强扫描-MRI(DCE-MRI) 高频彩超 META分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]