MR扩散加权成像对乳腺病变良恶性鉴别的Meta分析报告

目的 采用Meta分析方法综合定量评价MR扩散加权成像(DWI)对乳腺良恶性病变的鉴别诊断价值.方法 检索Cochrane图书馆、Pubmed、Ovid循证医学数据库、Elsevier和Springer数据库及中国期刊网1997至2007年公开发表的中英文文献,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献,提取纳入研究的特征信息.采用Q检验和Meta分析对纳入文献行统计学处理.结果 共纳入文献6篇,研究病灶共计479个.DWI诊断乳腺病变良恶性的敏感度范围为64.0%.92.8%,特异度范围为45.8%～96.7%.纳入文献具同质性,按照固定效应模型计算出的汇总加权敏感度和特异度及95%可信区间分别为86%(76%～92%)和80%(61%～91%);汇总受试者工作特征曲线(SROC)下面积为92.19%.敏感度分析显示纳入文献稳定性好.结论 DWI的表观扩散系数(ADC)值测量有助于乳腺病变的良恶性鉴别,但缺乏统一的扩散敏感因子(b)值和诊断阈值,其临床应用价值仍有待于前瞻性研究进一步证实.

Analysis of diffusion-weighted MR in the differential diagnosis of benign and malignant breast lesions with Meta-analysis

Objective To evaluate the value of diffusion.weighted imaging(DWI)in the differential diagnosis of benign and malignant breast lesions with Meta.analysis.Methods English and Chinese articles published from 1997 to 2007 were searched in Cochrane library,Pubmed,Ovid.Elsevier.Springer databases and Chinese National Knowledge Infrastructure(CNKI),and selected according to the criteria for diagnostic research recommended by Cochrane Method Group.The characteristics of selected articles including the study background,design,results and diagnostic indicators were analyzed.Statistical analysis was performed with Meta-test version 0.9.Results Six articles were included with a total of 479 lesions.The sensitivity and specificity of DWI for breast 1esions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity.and a fixation effects regression Was developed.The pooled weighted sensitivity and specificity with 95% CI and Az Was 86%(76%-92%).80%(61%-91%)and 92.19% respectively.Sensitivity analysis demonstrated no remarkable change on heterogeneity.Condnsion The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity.The further study is needed to assess the clinical aplication of the b-value and diagnostic threshold.