超微血管成像对动脉硬化斑块内新生血管的预测价值  

The predictive value of Superb Microvascular Imaging in intra-plaque neovascularization

作　　者：刘慧[1] 柏刚[1] LIU Hui;BAI Gang(Department of Ultrasound,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属太和医院)超声医学科,湖北十堰442000

出　　处：《中国优生与遗传杂志》2021年第1期34-38,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨超微血管成像模式(superbmicrovascularimaging,SMI)对颈动脉粥样硬化斑块内新生血管(intra-plaque neovascularization,IPN)检出的预测价值。方法全面检索Cochrane Library、PubMed、CBM、CNKI数据库中有关超微血管成像模式诊断颈动脉硬化斑块的文献资料,语言限定为中文及英文,检索时间止于2020年5月,使用QUADAS(QualityAssessmentofDiagnostic AccuracyStudies)工具筛选文献并提取资料,进行基于双变量模型的诊断性试验meta分析,用灵敏度(Sen)、特异度(Spe)、阳性似然比(LR+)、阴性似然比(LR–)、曲线下面积(AUC)来判断SMI的诊断准确性。结果 8个研究525患者最终纳入分析,方法学评估显示纳入研究的质量中等,异质性检验(Q=19.53,I2=90%)提示存在高度异质性。SMI对诊断IPN的合并敏感性和特异性分别为0.97(95%CI:0.91~0.99)和0.95(95%CI:0.53~1.00)。合并诊断优势比(DOR)为572(95%CI:39~8433),曲线下面积为0.968.数字化结果显示,线性回归检验P=0.606,提示无明显发表偏倚。结论现有研究证据表明,超微血管成像模式可显示斑块内新生血管,可作为常规超声的有力补充,对易损颈动脉斑块提供影像学依据,便于临床进一步处理预防脑卒中,具有临床应用前景,但是与传统其他方法相比是否提高了诊断准确率,还需进一步研究。Objective To explore the superb microvascular imaging(SMI) was used to predict the detection of intra-plaque neovascularization(IPN). Methods Comprehensive the literatures about the diagnosis of atherosclerotic plaques by the mode of ultra-fine angiography in Cochrane Library, PubMed, CBM and CNKI databases, the language is limited to Chinese and English, with a publication date through May 2020. Using the QUADAS(quality assessment of diagnostic accuracy studies) tool to screen literature and extract data, the diagnostic test meta-analysis based on bivariate model was carried out. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the area under the curve was used to judge the diagnostic accuracy of SMI. Results A total of 8 studies 525 patients were included, Methodological assessment revealed study quality was moderate, Heterogeneity test(Q=19.53, I2=90%) indicates that there is high heterogeneity in the study. The pooled sensitivity and specificity of SMI were 0.97(95%CI: 0.91–0.99) and 0.95(95%CI: 0.53–1.00), respectively. The summary diagnostic odds ratio was572(95%CI: 39–8433), and the area under the curve was 0.968. The digital results showed that the linear regression test P=0.606, indicating no significant publication bias. Conclusion The existing research evidence shows that the SMI mode can find neovascularization in the plaque, which can be used as a powerful supplement to the conventional ultrasound, provide the imaging basis for vulnerable carotid plaque, facilitate the clinical further treatment and prevention of stroke, and has a clinical application prospect, but whether it improves the diagnostic accuracy compared with other traditional methods needs further study.

关 键 词：超微血管成像 颈动脉斑块 新生血管 meta分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]