双能CT和超声诊断痛风效能的系统评价

Systematic review on the efficacy of dual-energy CT and ultrasound in the diagnosis of gout

目的系统评价超声和双能CT(DECT)诊断痛风的效能。方法检索PubMed、Embase、Cochrane Library、CNKI、WanFang Data及CBM数据库,时间截至2018年6月30日,查找DECT诊断痛风的诊断准确性试验和超声诊断痛风的诊断准确性试验。由4名研究员根据纳入标准和排除标准两两独立筛选文献、提取资料,采用QUADAS-2条目对纳入研究的方法学质量进行评价,采用Meta-Disc1.4软件对其敏感性(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)进行异质性检验和meta分析,绘制综合受试者工作特征(SROC)曲线,计算曲线下面积(AUC)。结果DECT纳入22例研究共1999例研究对象,超声纳入10例研究共941例研究对象。Meta分析结果显示:DECT SEN合并为0.91[95%CI(0.90,0.93)]、SPE合并为0.92[95%CI(0.90,0.94)]、AUC为0.9725。超声SEN合并为0.77[95%CI(0.73,0.80)]、SPE合并为0.88[95%CI(0.85,0.91)]、AUC为0.8993。结论DECT的诊断效能高于超声。

Objective To assess the efficacy of ultrasound and dual-energy CT(DECT)in the diagnosis of gout.Methods PubMed,Embase,Cochrane Library,CNKI,Wanfang Data and CBM database were searched for the studies about diagnostic accuracy of DECT and ultrasound in gout.The deadline for the search was June 30,2018.Four researchers screened and extracted data based on the inclusion and exclusion criteria,with two people in one group.The QUADAS-2 entry was used to evaluate the methodological quality of the included studies.The heterogeneity test Meta-analysis were conducted on sensitivity(SEN),specificity(SPE),positive likelihood ratio(+LR)and negative likelihood ratio(-LR)with the use of Meta-Disc 1.4.The summary receiver operating characteristics(SROC)curve was plotted,and the area under the curve(AUC)was calculated.Results DECT was included in 22 studies involving 1999 subjects,and ultrasound was included in 10 studies involving 941 subjects.The SEN,SPE and AUC of in the combined studies including DECT were 0.91(CI 95%[0.90,0.93]),0.92(CI 95%[0.90,0.94])and 0.9725,respectively,and those in the combined studies including ultrasound were 0.77(CI 0.95%[0.73,0.80]),0.88(CI 0.95%[0.85,0.91])and 0.8993.Conclusion DECT has a higher diagnostic efficacy than ultrasound.