剪切波弹性成像对腕管综合征诊断价值的系统评价  

Diagnostic value of shear wave elastography for carpal tunnel syndrome:A systematic review

作　　者：汤雪瑶 傅文会 宣吉晴 敖梦[3] 李明星 TANG Xueyao;FU Wenhui;XUAN Jiqing;AO Meng;LI Mingxing(Department of Ultrasound,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;不详)

机构地区：[1]西南医科大学附属医院超声科,四川泸州646000 [2]西南医科大学附属医院核医学科,四川泸州646000 [3]重庆医科大学附属第二医院超声科,重庆400010

出　　处：《实用医学杂志》2020年第16期2249-2254,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81501482);四川省医学科研青年创新课题(编号:Q17081)。

摘　　要：目的系统评价剪切波弹性成像(shear wave elastography,SWE)对腕管综合征(carpal tunnel syndrome,CTS)的诊断价值。方法计算机检索PubMed、EMbase、The Cochrane Library、中国知网(CNKI)、万方、维普(VIP)等数据库中有关SWE诊断CTS的诊断性试验,检索时间为建库至2020年3月,两名研究员筛选文献,提取数据,利用QUADAS-2工具评价纳入研究的偏倚风险,采用Meta Disc 1.4和Stata 12.0软件进行Meta分析。结果共纳入12篇文献,Meta分析结果显示:SWE诊断CTS的合并敏感性、特异性、阳性似然比、阴性似然比、诊断比值比分别为0.82(0.79,0.85)、0.82(0.78,0.85)、3.97(2.94,5.37)、0.23(0.16,0.33)、18.74(10.65,32.99),曲线下面积为0.88。亚组分析显示:剪切模量值的诊断价值高于剪切波速度,其中,相较于前臂区距离腕横纹上5 cm处正中神经弹性模量均值(WEmean)和同一感兴趣区内正中神经与指浅屈肌腱二者的弹性模量均值比(FRatio),豌豆骨水平处正中神经弹性模量均值(FEmean)对CTS的诊断具有更高的敏感性和特异性。结论SWE对诊断CTS具有明确的诊断价值,特别是在使用剪切模量值作为阈值的条件下。Objective To systematically review the value of shear wave elastography(SWE)in the detection of carpal tunnel syndrome(CTS).Methods Literatures that evaluated the diagnostic potency of SWE in CTS until March 2020 were searched in databases including PubMed,Embase,The Cochrane Library,CNKI,Wan Fang and VIP.Two researchers screened the literature,extracted the data,and evaluated the risk of bias of included studies based on the Quality Assessment of Diagnostic Accuracy Studies-2 tool.The meta-analysis was performed using Meta Disc 1.4 and Stata 12.0 software.Results A total of 12 articles were included.The results of metaanalysis showed that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio were 0.82(0.79,0.85),0.82(0.78,0.85),3.97(2.94,5.37),0.23(0.16,0.33),18.74(10.65,32.99),respectively.The areas under the curves was 0.88.Subgroup analysis showed that the diagnosis value of Young’s modulus was higher than that of shear wave velocity.Among them,compared with WEmean and FRatio,WFmean has higher sensitivity and specificity for the diagnosis of CTS.Conclusion SWE has high accuracy in the detection of CTS,especially under the condition of using the value of Young’s modulus as the threshold.

关 键 词：腕管综合征 弹性成像 系统评价 META分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R746[医药卫生—诊断学]