DTI参数诊断早期放射性脑损伤Meta分析

A meta-analysis of diffusion tensor imaging for diagnosis of early radiation-induced brain injury

目的 分析DTI多参数指标对早期放疗后脑损伤的诊断价值.方法 通过检索中国知网和PubMed数据库,根据PRISMA协议纳入标准文献,进行FA值、λ｜｜和λ丄的汇总,绘制森林图、累计分析、敏感性分析以及回归分析,且绘制漏斗图分析发表偏倚.结果 总共筛选了11篇文章进行Meta分析,FA值异质性检验结果：在中国P=0.000,I2=93.6%;在其他国家及地区P=0.004,I2=82.2%,总P=0.000,I2=91.5%.时间剂量依赖性、科研设计方法回归分析分别为Adjusted P=0.026、P=0.005和Adjusted P=0.859、P=0.908.λ｜｜和λ丄异质性检验结果为P=0.908,I2=0.0%和P=0.100,I2=56.6%.Egger＇s检验系数为-6.26（95%CI为-9.31^-3.20,P=0.001）,Begg＇s检验结果为P=0.004.结论 DTI的多种参数指标对于诊断早期放射性脑损伤较敏感,是一种比较可靠的方法.

Objective To analyze the diagnostic value of diffusion tensor imaging （DTI） for early radiation-induced brain injury.Methods We searched CNKI and PubMed and included articles according to the PRISMA statement.FA value, λ｜｜, and λ丄 were pooled, and Forest plot generation, cumulative analysis, sensitivity analysis, and regression analysis were performed.We also used the funnel plot to analyze publication bias.Results A total 11 studies were included for meta-analysis.The results of FA value heterogeneity test were as follows：P=0.000, I2=93.6% in China;P=0.004, I2=82.2% in other countries and regions;P=0.000, I2=91.5% in all regions.The regression analysis of time-dose dependence and study design showed significant and non-significant associations, respectively, with the heterogeneity of these studies （adjusted P=0.026, P=0.005;adjusted P=0.859, P=0.908）.The results of λ｜｜and λ丄 heterogeneity tests were as follows：P=0.908, I2=0.0%;P=0.100, I2=56.6%.There was a sign of publication bias by Egger＇s test （coefficient：-6.26, 95%CI：-9.31 to-3.20, P=0.001） and Begg＇s test （P=0.004）.Conclusions DTI-derived metrics are sensitive and reliable in the diagnosis of early radiation-induced brain injury.