CT引导下穿刺活检联合快速现场评价对肺部病灶诊断价值的系统评价  

Systematic Evaluation of the Diagnostic Value of Computed Tomography-guided Puncture Biopsy Combined with Rapid On-site Evaluation for Pulmonary Lesions

作　　者：张中宝 李元 张凯 张晓琴 ZHANG Zhongbao;LI Yuan;ZHANG Kai;ZHANG Xiaoqin(Department of Radiology,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010000,China)

机构地区：[1]内蒙古自治区人民医院影像医学科,呼和浩特010000

出　　处：《CT理论与应用研究（中英文）》2024年第2期197-205,共9页Computerized Tomography Theory and Applications

基　　金：内蒙古自治区科技厅应用技术研究与开发资金(2021GG0128)。

摘　　要：目的:探讨CT引导下穿刺活检联合快速现场评价对肺部病灶的诊断价值。方法:截至2022年10月,系统检索PubMed和EMBASE数据库,查找所有国外公开发表的文献研究,采用PRISMA推荐的质量评价工具(QUADAS-2)作为评估偏倚风险的主要方法,应用Meta分析软件对数据进行异质性检验,根据异质性结果选择相应的效应模型,计算总灵敏度、特异度、诊断优势比(DOR),并绘制综合受试者工作特征曲线(SROC)、森林图与漏斗图。结果:纳入研究6篇(n=951例),采用随机效应模型分析,汇总灵敏度、特异度、诊断优势比及其95%置信区间分别为94%、95%、159.05,SROC AUC为0.98。对设立对照组的4项研究进一步分析,与非ROSE组比较,ROSE组取材充分性、诊断准确性分别提高12%和13%。结论:对于肺部病灶,CT引导下穿刺活检联合快速现场评价是一项切实可行的操作方法,可作为重要临床诊断方法之一。Background:To investigate the diagnostic value of computed tomography(CT)-guided aspiration biopsy combined with rapid field evaluation for pulmonary lesions.Methods:The PubMed and EMBASE databases were searched systematically for studies related to the diagnosis of lung lesions by CT-guided puncture biopsy combined with a rapid on-site indexed through October 2022.The updated Quality Assessment of Diagnostic Accuracy Studies(QUADAS-2)tool was applied as the main method to assess the risk of bias and applicability of the studies.Meta-analysis software was used to perform heterogeneity tests on the data.Based on the heterogeneity results,the appropriate effect model was selected to calculate the overall sensitivity,specificity,and diagnostic odds ratio(DOR),and to plot the summary receiver operating characteristic(SROC)curve,forest plot,and funnel plot.The results of the analysis of six studies(n=951)using a random-effects model showed pooled sensitivity,specificity,and diagnostic odds ratio with 95%confidence intervals of 94%,95%,and 159.05,respectively,with an SROC AUC of 0.98.Further analysis of the four studies that established control groups showed that the sampling adequacy and diagnostic accuracy in the ROSE group were 12%and 13%higher than those in the non-ROSE group.In conclusion,CT-guided puncture biopsy combined with rapid on-site evaluation is a practical and feasible method for diagnosing pulmonary lesions and can be used as an important clinical diagnostic method.

关 键 词：CT引导下穿刺活检 快速现场评价 系统评价 

分 类 号：R814[医药卫生—影像医学与核医学] O212[医药卫生—放射医学]