扩散加权成像鉴别胰腺癌与肿块型慢性胰腺炎的Meta分析

Evaluation of Diffusion-Weighted Imaging in Distinguishing Pancreatic Carcinoma from Mass- Forming Chronic Pancreatitis: A Meta Analysis

目的对磁共振扩散加权成像(DWI)鉴别诊断胰腺癌和肿块型慢性胰腺炎的文献进行汇总复习,评价DWI对胰腺癌与肿块型慢性胰腺炎的鉴别诊断价值。方法检索主要中、英文数据库,提取相关参数,采用Stata12.0及Meta-Disc 1.4软件进行Meta分析。结果 DWI对该两种疾病鉴别诊断汇总敏感度为0.864(95%CI:0.799,0.910),汇总特异度为0.816(95%CI:0.716,0.886),汇总阳性似然比4.694(95%CI:3.013,7.312),汇总阴性似然比0.167(95%CI:0.114,0.244),汇总诊断比值比为28.137(95%CI:15.562,50.872),汇总受试者工作特征曲线(SROC)下面积(AUC)为0.91(95%CI:0.88,0.93)。结论 DWI用于鉴别诊断胰腺癌与肿块型慢性胰腺炎具有较高的诊断准确性。

Objective To make a comprehensive literature review of diffusion-weighted imaging （DWI） in differentia- ting pancreatic carcinoma with mass-forming chronic pancreatitis （MFCP） by using meta analysis, and to evaluate MR dif- fusion weighted imaging in differentiating pancreatic carcinoma with MFCP. Methods The main Chinese and English data base, including MEDLINE, EMBASE and Cochrane Library databases, CNKI, CBM, WAN FANG, etc. were researched for the studies concerning DWI differentiation of pancreatic carcinoma with mass-forming chronic pancreatitis. The relevant parameters were extracted, and meta analysis was conducted by using Stata 12.0 and Meta-Disc 1.4 software. Methodologi- cal quality was assessed by QUADAS tool. Results A total of 9 studies, with 417 patients who fulfilled all of the inclu- sion criteria, were selected for the analysis. The pooled sensitivity and specificity of DWI in differentiating pancreatic carci- noma with mass-forming chronic pancreatitis were 0. 864 （95% CI：0. 799, 0. 910） and 0. 816 （95% CI：0. 716, 0. 886） respectively. The LR ＋ and LR- were 4. 694 （95% C1：3. 013, 7. 312） and 0. 167 （95% C1：0.114, 0.244） respectively. DOR was 28. 137 （95 % CI ： 15. 562 - 50. 872）. The area under the curve of the summary receiver operating characteristic was 0.91 （95% C1：0, 88,0, 93 ）, Conclusion MR diffusion-weighted imaging carries higher diagnostic accuracy in dif- ferentiating pancreatic carcinoma with mass-forming chronic pancreatitis.