磁共振成像診斷肺栓塞價值的Meta分析_《中國循證醫學雜志》

作者：

盧星如 ¹ , 張皓 ¹ , 王浩 ¹ ,  王剛 ¹ , 包海榮 ² , 王文輝 ³ , 郭奇宏 ¹

1. 蘭州大學第一醫院放射科（蘭州 730000）；2. 蘭州大學第一醫院呼吸內科（蘭州 730000）；3. 蘭州大學第一醫院介入醫學科（蘭州 730000）;

關鍵詞：

磁共振成像肺栓塞 CT 肺血管造影 Meta分析系統評價診斷性試驗

DOI：

10.7507/1672-2531.20130028

視頻：

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目的　系統評價磁共振成像（MRI）診斷肺栓塞的價值，以期為臨床決策提供依據。
方法　計算機檢索PubMed、EMbase、Cochrane圖書館、CBM、CNKI和VIP等數據庫，查找MRI與金標準（CT肺血管造影）比較診斷肺栓塞的診斷性試驗，對納入研究進行資料提取并應用QUADAS條目進行方法學質量評估后，采用Meta-Disc 1.4軟件進行Meta分析，計算合并敏感度和特異度，并繪制匯總受試者工作特征曲線（SROC曲線）和計算曲線下面積，以評價MRI診斷肺栓塞的價值。
結果　共納入6篇英文文獻，595例患者。異質性檢驗結果顯示各納入研究結果間存在統計學異質性，采用隨機效應模型進行Meta分析，結果顯示其合并敏感度、特異度分別為0.87［95%CI（0.80，0.91）］和0.98［95%CI（0.96，0.99）］，SROC曲線下面積（AUC）為0.988 7。
結論　MRI是一種比較好的評價肺栓塞的無創性檢查方法，有較高的敏感度和特異度，具有很好的臨床應用價值。

引用本文： 盧星如,張皓,王浩,王剛,包海榮,王文輝,郭奇宏. 磁共振成像診斷肺栓塞價值的Meta分析. 中國循證醫學雜志, 2013, 13(2): 160-164. doi: 10.7507/1672-2531.20130028 復制

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1. Stang P, Morris L, Kempf J, et al. The coprescription of contraindicated drugs with statins: continuing potential for increased risk of adverse events. Am J Ther, 2007, 14(1): 30-40.
2. Cziraky MJ, Willey VJ, McKenney JM, et al. Statin safety: an assessment using an administrative claims database. American Journal of Cardiology, 2006, 97(8A): 61-68.
3. Wittram C, Kalra MK, Maher MM, et al. Acute and chronic pulmonary emboli: angiography-CT correlation. AJR Am J Roentgenol, 2006, 186(6 Suppl 2): 421-429.
4. Russo V, Piva T, Lovato L, et al. Multidetector CT: a new gold standard in the diagnosis of pulmonary embolism? State of the art and diagnostic algorithms. Radiol Med, 2005, 109(1-2): 49-61; quiz 62-63.
5. Straus SE. Evidence-based medicine: how to practice and teach EBM.3rd ed. Edinburgh; New York: Elsevier/Churchill Livingstone, 2005.
6. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25-38.
7. Zamora J, Abraira V, Muriel A, et al. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol, 2006, 12: 6-31.
8. Rajaram S, Swift AJ, Capener D, et al. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension. European Radiology, 2012, 22(2): 310-317.
9. Ishiyama M, Matsusako M, Oikado K, et al. Three-dimensional T2-weighted imaging using the dark blood method for detecting pulmonary embolisms: comparison with computed tomography angiography. Jpn J Radiol, 2011, 29(9): 667-672.
10. Stein PD, Chenevert TL, Fowler SE, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med, 2010, 152(7): 434-443, W142-143.
11. Kluge A, Luboldt W, Bachmann G. Acute pulmonary embolism to the subsegmental level: diagnostic accuracy of three MRI techniques compared with 16-MDCT. AJR Am J Roentgenol, 2006, 187(1): 7-14.
12. Pleszewski B, Chartrand-Lefebvre C, Qanadli SD, et al. Gadolinium-enhanced pulmonary magnetic resonance angiography in the diagnosis of acute pulmonary embolism: a prospective study on 48 patients. Clin Imaging, 2006, 30(3): 166-172.
13. Ohno Y, Higashino T, Takenaka D, et al. MR angiography with sensitivity encoding (SENSE) for suspected pulmonary embolism: comparison with MDCT and ventilation-perfusion scintigraphy. AJR Am J Roentgenol, 2004, 183(1): 91-98.

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《中國循證醫學雜志》

磁共振成像診斷肺栓塞價值的Meta分析

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《中國循證醫學雜志》

磁共振成像診斷肺栓塞價值的Meta分析

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