PET/CT结合HRCT诊断孤立性肺结节的应用价值:Meta分析

目的系统评价PET/CT与HRCT相结合诊断孤立性肺结节(solitary pulmonary nodule,SPN)的临床价值。方法计算机检索Pub Med、EMBASE、Cochrane Library、Web of Science、维普、万方、CBM和CNKI等中英文数据库,检索并筛选出有关PET/CT与HRCT相结合诊断SPN的研究。提取数据,采用Meta-Di Sc 1.4及Rev Man 5.0软件对所提取数据进行统计分析。结果最终纳入8篇文献,包括538个结节。Meta分析结果显示:与金标准相比,PET/CT、HRCT、PET/CT结合HRCT诊断SPN的敏感度分别为PET/CT 0.91(0.86-0.94)、HRCT 0.88(0.80-0.93)、PET/CT结合HRCT 0.96(0.93-0.98);特异度分别为:PET/CT 0.65(0.59-0.70)、HRCT 0.85(0.76-0.92)、PET/CT结合HRCT 0.93(0.89-0.96);诊断比值比分别为:PET/CT 23.08(13.48-39.52)、HRCT45.86(19.42-108.29)、PET/CT结合HRCT306.49(125.93-745.94);SROC曲线下的面积分别为0.8967,0.9351,0.9844。结论PET/CT结合HRCT综合分析提高了诊断SPN的敏感性、特异性及准确性,其诊断效能明显优于单独使用PET/CT或HRCT,在SPN的良恶性鉴别方面更具优势,为临床诊断提供帮助,从而避免不必要的手术。

Meta-analysis of PET/CT Integrated High Resolution CT in Diagnosing Solitary Pulmonary Nodules

Objective The study aims for an overall evaluation of the clinical value of differential diagnosis of solitary pulmonary nodule (SPN) with PET/CT integrated high resolution CT(HRCT) by using a meta-analysis. Methods Such databases as PubMed, EMBASE, Cochrane Library, Web of Science, VIP, Wanfang, CBM and CNKI were searched and screened for articles about using PET/CT and HRCT to diagnose SPN. The Metadisc1.4 and RevMan 5.0 software were used to analyze the data. Results A total of 8 articles were included finally, involving 538 nodules. The meta-analysis showed that, compared with reference standard, the summary sensitivity, specificity, diagnostic odds ratio and area under SROC curve for PET/CT, HRCT, PET/CT integrated HRCT diagnosing SPN were 0.91(0.86-0.94), 0.65(0.59-0.70), 23.08(13.48-39.52) and 0.8967;0.88(0.80-0.93), 0.85(0.76-0.92), 45.86 (19.42-108.29) and 0.9351, 0.96(0.93-0.98), 0.93(0.89-0.96), 306.49(125.93-745.94), 0.9844), respectively. Conclusion The comprehensive analysis by combining PET/CT and HRCT can greatly improve the sensitivity, specificity and accuracy in the diagnosis of SPN, and has superior diagnosis efficiency than use PET/CT or HRCT alone, and has more advantage in differentiation of benign and malignant SPN, so as to avoid unnecessary surgery.