多层螺旋CT对冠状动脉支架内再狭窄诊断价值的meta分析

Clinical Application of MSCT in Diagnosing In-stent Restenosis of Coronary Artery:A Meta Analysis

目的系统评价多层螺旋CT（≥128层）对诊断冠状动脉支架内再狭窄（ISR）的诊断价值。方法计算机检索建库至2013年9月Pubmed,Embase,Cochrane library,web of science,CNKI,CBM,万方数字化期刊,维普数字化期刊数据库,查询MSCT（≥128层）在诊断冠状动脉ISR研究的中、英文文献。对纳入文献进行质量评估,计算MSCT（≥128层）诊断冠状动脉ISR灵敏度（SEN）、特异度（SPE）及其95%可信区间（CI）,绘制及计算受试者工作特征曲线（SROC）和曲线下面积（AUC）。结果共纳入12篇文献。基于支架分析,MSCT（≥128层）诊断冠状动脉ISR的SEN为0.90（95%CI：0.82～0.94）,SPE为0.91（95%CI：0.89～0.93）,AUC为0.95。亚组分析320层MSCT诊断冠状动脉ISR的SEN和SPE0.93（95%CI：0.85～0.97）和0.95（95%CI：0.89～0.98）。结论 MSCT（≥128层）对评价冠状动脉ISR具有较高的价值,是其临床随访的一种有效且无创的检查方法。

Objective To evaluate multi-slice （≥ 128 slices ） spiral CT （MSCT） in diagnosing in-stent restenosis of coronary artery. Methods The Chinese and English medical literatures concerning MSCT （≥ 128 slices） diagnosis of in- stent restenosis of coronary artery were searched from Pubmed, Emhase, Cochrane library, web of science, CNKI, CBM, Wan Fang digital periodicals, VIP digital periodicals database, etc. which were published within the period from the estab- lishment of computer database to September 2013. The qualities of the documents were assessed. The sensitivity （ SE）, specificity （SP） and 95% CI of MSCT diagnosis of in-stent restenosis of coronary artery were calculated, and summary re- ceiver operating characteristic （SROC） curve and area under curve （AUC） were drawn and calculated. Results A total of 12 documents were enrolled in this study. Based on stent analysis, the merger SE and SP of MSCT （ ≥ 128 slices） for the diagnosis of in-stent restenosis of coronary artery were 0.90 （ 95 % C1：0.82 - 0.94 ） and 0.91 （ 95 % CI ： 0.89 - 0.93 ） respectively, and the AUC was 0.95. Subgroup analysis showed that the sensitivity and specificity of 320-slice MSCT for the diagnosis of in-stent restenosis of coronary artery were 0.93 （95% CI：0.85 -0.97） and 0.95 （95% CI：0.89 -0.98）respectively. Conclusion MSCT （ ≥128 slices） scanning has higher value in evaluating in-stent restenosis of coronary artery. This technique is an effective and non-invasive examination.