体素内不相干运动扩散加权成像对肺部良恶性病变鉴别效能的Meta分析  

The diagnostic performance of intravoxel incoherent motion diffusion weighted imaging in differentiating benign from malignant lung lesions:a Meta-analysis

作　　者：池亚男 李法升 CHI Ya’nan;LI Fasheng(Medical Imaging Center,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Imaging,the Fifth Affiliated Hospital of Jinan University,Heyuan,Guangdong Province 517475,China)

机构地区：[1]暨南大学附属第一医院医学影像中心,广东广州510630 [2]暨南大学附属第五医院影像科,广东河源517475

出　　处：《实用放射学杂志》2023年第2期204-209,共6页Journal of Practical Radiology

摘　　要：目的运用Meta分析方法汇总并评价体素内不相干运动扩散加权成像(IVIM-DWI)对肺癌与肺部良性病变的鉴别诊断效能。方法在PubMed、Web of Science、中国知网(CNKI)和万方数据库中检索自建库以来至2020年6月发表的有关IVIM-DWI鉴别肺癌和肺部良性病变的中英文文献,对纳入文献进行质量评价后提取相关数据,应用Review Manager 5.3对2组病变纯扩散系数(D)值、灌注相关扩散系数(D*)值和灌注分数(f)值的平均值及标准差进行分析,比较2组病变标准化平均数差值(SMD)的差异。利用Stata 12.0合并各指标的诊断效能。结果共纳入文献12篇,含肺癌529例,肺部良性病变306例。除D*值外(SMD=0.01,P=0.96),肺癌的D值(SMD=-1.02,P<0.001)及f值(SMD=-0.43,P=0.005)均低于肺部良性病变,差异有统计学意义。D值的诊断效能最高,其敏感度、特异度、曲线下面积(AUC)、验后概率分别为89%、71%、0.90、57%,其次为f值(敏感度、特异度、AUC、验后概率分别为71%、61%、0.71、43%)和D*值(敏感度、特异度、AUC、验后概率分别为70%、60%、0.66、43%)。结论IVIM-DWI可用于肺部良恶性病变性质的诊断,其中以D值的诊断效能最高。Objective To summarize and evaluate the diagnostic performance of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)in differentiating benign lung lesions from lung cancer via a Meta-analysis method.Methods The studies publised at home and abroad regarding the differential diagnosis of lung cancer and benign lung lesions based on IVIM-DWI were systemically searched via PubMed,Web of Science,China National Knowledge Infrastructure(CNKI)and Wanfang database from inception to June 2020.Data extracted from the eligible literatures after performing quality assessment,including the mean value,standard deviation and the standardized mean difference(SMD)of the D value,the D*value as well as the f value,were calculated and measured via Review Manager 5.3,and Stata 12.0 was performed to combine their diagnostic performances with each other.Results A total of 12 studies with 529 lung cancer and 306 benign lung lesions were finally included.D value(SMD=-1.02,P<0.001)and f value(SMD=-0.43,P=0.005)of lung cancer were significantly lower than those of benign lung lesions,while there was no significant difference in D*value(SMD=0.01,P=0.96)between lung cancer and benign lung lesions.The D value demonstrated the best diagnostic performance in differentiating lung cancer from benign lung lesions,[sensitivity=89%,specificity=71%,area under the curve(AUC)=0.90 and post-test probability=57%,respectively]followed by f value(sensitivity=71%,specificity=61%,AUC=0.71 and post-test probability=43%,respectively)and D*value(sensitivity=70%,specificity=60%,AUC=0.66 and post-test probability=43%,respectively).Conclusion The IVIM-DWI parameters,particularly D value,show potentially strong diagnostic capabilities in the differential diagnosis of benign from malignant lung lesions.

关 键 词：肺癌 体素内不相干运动扩散加权成像 META分析 磁共振成像 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]