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作 者:吴梅[1] 郭启勇[1] 马春梅[1] 黄蓓婷[2] 孙鹏
机构地区:[1]中国医科大学附属第二医院放射科,辽宁沈阳110004 [2]中国医科大学附属第一医院流行病教研室
出 处:《中国医学影像技术》2004年第4期608-613,共6页Chinese Journal of Medical Imaging Technology
摘 要:目的 通过meta分析对目前诊断梗阻性黄疸的非侵入性影像诊断方法 (US ,CT和MRCP)进行对比研究。方法 采用MEDLINE文献查询及参考文献的复习。两名专家独立进行资料的选入及剔除。纳入标准为 :1980年 1月到2 0 0 3年 7月发表的文献 ,(a)US、CT和MRCP诊断梗阻性黄疸性疾病的文献 ,(b)病理结果为金标准 ,(c)能够直接或间接获得每个影像方法的真、假阳性数 ,真、假阴性数。进行SROC分析以及协变量分析各研究因素对敏感性的影响。结果 45篇文献 ,17篇有关US(2 0 17例 ) ,12篇有关CT(75 2例 ) ,2 0篇有关MRCP(12 92例 )符合纳入标准。SROC曲线分析表明MRCP比US和CT具有更高的诊断能力 ,MRCP的Q 值 (0 .92 5 6)高于US(0 .8765 )和CT(0 .860 6)。结论 诊断胆道梗阻性疾病的非侵入性影像诊断方法中 ,MRCP比US和CT具有更高的诊断效能。Objective To perform a meta-analysis to compare current noninvasive imaging methods (ultrasonography [US],computed tomography [CT],magnetic resonance cholangiopancreatography [MRCP]) in the detection of obstructive jaundice disease. Methods A MEDLINE literature search and review of article bibliographies were done. Two authors independently abstracted and excluded data sets. Literatures published between January 1980 and July 2003 were included if: (a) US,CT and/or MRCP were performed for evaluation of obstructive jaundice disease,(b) Pathological results or operational findings was the reference standard,(c) Absolute numbers of true-positive,false-negative, true-negative and false-positive results were available or derivable. Summary receiver operating characteristic (SROC) were obtained and a covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity. Results Among 45 data sets,17 US (2017 patients),12 CT (752 patients) and 20 MRCP (1292 patients) data sets met the inclusion criteria. Summary receiver operating characteristic analysis demonstrated better discriminatory power for MRCP than for US and CT. The value of Q * for MRCP (0.9256) was higher than that for US (0.8765)and CT (0.8606). Conclusion MRCP has better discriminatory power than does US and CT for the work-up for obstructive jaundice disease.
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