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目的通过Meta分析研究方法对弥散加权成像磁共振检查方法评价肝纤维化分级诊断的准确性做出分析。方法通过检索国内外公开发表的DWI评价肝纤维化分级诊断准确性的文章,并且采用Metavir、Scheuer、Batts-Ludwig计分系统标准进行分级。两名研究人员按照纳入与排除标准独立选择文献并根据QUADAS评价条目标准进行质量评价。使用MetaDisc软件进行Meta分析,并绘制SROC曲线。结果检索到247篇相关文献,最终纳入了10项1.5 T场强研究和3项3.0 T场强研究,受试者总数为809例。Meta分析结果示各组间存在统计学异质性,采用随机效应模型合并分析。DWI磁共振检查方法对轻度肝纤维化(G1)组、明显肝纤维化(G2)组、严重肝纤维化(G3)组、早期肝硬化(G4)组的合并灵敏度和特异度分别为:0.74和0.74、0.83和0.76、0.78和0.79、0.83和0.79;SROC曲线下面积分别为:0.8363、0.8820、0.8663和0.8719。结论DWI对肝纤维化分级具有较高的诊断效能。
OBJECTIVE: To analyze the accuracy of diffusion-weighted imaging (MR) magnetic resonance imaging (MRA) in assessing the classification of liver fibrosis by Meta analysis. Methods We searched articles published by domestic and foreign researchers to evaluate the accuracy of DWI in diagnosing hepatic fibrosis and classified them by Metavir, Scheuer and Batts-Ludwig scoring system. Two researchers independently selected the literature according to inclusion and exclusion criteria and assessed the quality according to the QUADAS evaluation entry criteria. Meta-analysis was performed using MetaDisc software and the SROC curve was plotted. Results A total of 247 related articles were retrieved. Finally, 10 1.5T field strength studies and 3 3.0T field strength studies were included, with a total of 809 subjects. Meta-analysis showed statistical heterogeneity among the groups and was analyzed using a random-effect model. The combined sensitivity and specificity of DWI method for mild liver fibrosis (G1) group, significant liver fibrosis (G2) group, severe liver fibrosis (G3) group, early liver cirrhosis (G4) group were: 0.74 and 0.74, 0.83 and 0.76, 0.78 and 0.79, 0.83 and 0.79, respectively; the area under the SROC curve was 0.8363, 0.8820, 0.8663 and 0.8719, respectively. Conclusion DWI has high diagnostic efficiency in the classification of liver fibrosis.