单、双指数模型扩散加权成像预测肝细胞癌微血管侵犯的Meta分析  

Diagnostic value of mono-exponential and bi-exponential models of diffusion-weighted imaging for microvascular invasion of hepatocellular carcinoma:a Meta-analysis

作　　者：邝咏瑶 江梓杰 叶坤林 梁建业 肖泽宇[1] 史长征[1] 罗良平[1] KUANG Yongyao;JIANG Zijie;YE Kunlin;LIANG Jianye;XIAO Zeyu;SHI Changzheng;LUO Liangping(Medical Imaging Center,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China;Department of Radiology,Shunde Hospital of Southern Medical University,Foshan,Guangdong Province 528300,China;Department of Medical Imaging,Cancer Center,Sun Yat-sen University,Guangzhou 510060,China)

机构地区：[1]暨南大学附属第一医院影像中心,广东广州510632 [2]南方医科大学顺德医院放射科,广东佛山528300 [3]中山大学肿瘤防治中心影像科,广东广州510060

出　　处：《实用放射学杂志》2021年第9期1468-1472,1487,共6页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81771973,81971672);广东省自然科学基金重点项目(2018B0303110011);广州市分子与功能影像临床转化重点实验室(201905010003).

摘　　要：目的以Meta分析的方法评价并比较单、双指数模型扩散加权成像(DWI)对肝细胞癌的微血管侵犯(MVI)的预测能力.方法检索the Cochrane Library、Embase、PubMed、中国学术期刊网全文数据库、万方数据库收录至2020年10月的应用单、双指数模型DWI评估肝细胞癌的MVI的中英文文献,根据制定的标准筛选文献,摘取相关资料,并计算汇总效应量.结果纳入中、英文文献共15篇.其中表观扩散系数(ADC)值诊断的汇总敏感度、特异度、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)以及综合受试者工作特征(SROC)曲线的曲线下面积(AUC)分别为0.75[95%置信区间(CI)(0.68~0.82)]、0.72(0.65~0.78)、2.66(2.14~3.29)、0.34(0.26~0.45)、7.75(5.25~11.45)及0.80(0.76~0.83).而真实扩散系数(D)值的对应结果分别为0.88(0.73~0.95)、0.69(0.55~0.81)、2.86(2.01~4.08)、0.17(0.08~0.38)、16.69(7.78~35.80)及0.85(0.82~0.88).结论单、双指数模型DWI在预测肝细胞癌的MVI有较高的诊断价值,D值的诊断效能优于ADC值.Objective To summarize and compare the diagnostic value of mono-exponential and bi-exponential models of diffusion-weighted imaging(DWI)in predicting microvascular invasion(MVI)of hepatocellular carcinoma.Methods Literature regarding mono-exponential and bi-exponential models of DWI in predicting MVI of hepatocellular carcinoma were searched in the Cochrane Library,Embase,PubMed,China National Knowledge Infrastructure databases and Wanfang database up to October,2020.And we screened the studies according to the criteria,extracted related information and figured out the pooled results.Results A total of 15 studies in Chinese or English were included in this Meta-analysis.The pooled sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),and diagnostic odds ratio(DOR)of apparent diffusion coefficient(ADC)in detecting MVI were 0.75[95%confidence interval(CI)(0.68-0.82)],0.72(0.65-0.78),2.66(2.14-3.29),0.34(0.26-0.45),and 7.75(5.25-11.45).respectively,with an area under the curve(AUC)0.80(0.76-0.83).The corresponding results of the D value were 0.88(0.73-0.95),0.69(0.55-0.81),2.86(2.01-4.08),0.17(0.08-0.38),16.69(7.78-35.80)and 0.85(0.82-0.88).respectively.Conclusion Mono-exponential and bi-exponential models of DWI has a high diagnostic value in predicting MVI of hepatocellular carcinoma.Also,the D value is superior to ADC in terms of MVI detection.

关 键 词：肝细胞癌 微血管侵犯 扩散加权成像 体素内不相干运动 META分析 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]