实时剪切波弹性成像评价肝纤维化分级的Meta分析

Value of real-time shear wave elastography in evaluating classification of liver fibrosis: a Meta-analysis

目的应用Meta分析评价实时剪切波弹性成像(SWE)技术对肝纤维化分级的诊断价值。方法对2010年1月-2016年12月Pubmed、中国知网、中国生物医学文献数据库、维普和万方等数据库中有关SWE评价肝纤维化分级的中、英文文献进行筛选和评价,应用Meta-disc 1.4软件对入选文献各项数据进行整合分析。结果共纳入11篇英文文献,总病例数为1560例。SWE对≥F2组的合并敏感度、特异度、诊断比值比(DOR)分别为0.85[95%可信区间(95%CI):0.82~0.87]、0.79(95%CI:0.76~0.82)、30.81(95%CI:16.55~57.34);≥F3组的合并敏感度、特异度、DOR分别0.87(95%CI:0.84~0.91)、0.84(95%CI:0.82~0.87)、41.45(95%CI:18.25~94.45);F4组的合并敏感度、特异度、DOR分别0.88(95%CI:0.83~0.91)、0.91(95%CI:0.89~0.92)、67.18(95%CI:30.03~150.31)。3组的曲线下面积分别为0.914 7、0.922 3和0.952 0。结论 SWE技术对判断肝纤维化分级具有较高的诊断价值,在临床上可用于肝纤维化分期。

Objective To investigate the diagnostic value of real-time shear wave elastography（ SWE） technique in evaluating classification of liver fibrosis. Methods Pub Med,CNKI,CBM,VIP,and Wanfang Data were searched for Chinese and English articles on SWE for evaluating classification of liver fibrosis published from January 2010 to December 2016,and these articles were screened and evaluated.Meta-disc 1. 4 software was used for the meta-analysis of the data in the articles included. Results A total of 11 English articles were included,with 1560 cases in total. In the ≥F2 group,SWE had a pooled sensitivity of 0. 85（ 95% confidence interval [CI]： 0. 82-0. 87）,a specificity of 0. 79（ 95% CI： 0. 76-0. 82）,and a diagnostic odds ratio（ DOR） of 30. 81（ 95% CI： 16. 55-57. 34）. In the ≥F3 group,SWE had a pooled sensitivity of 0. 87（ 95% CI： 0. 84-0. 91）,a specificity of 0. 84（ 95% CI： 0. 82-0. 87）,and a DOR of 41. 45（ 95%CI： 18. 25-94. 45）. In the F4 group,SWE had a pooled sensitivity of 0. 88（ 95% CI： 0. 83-0. 91）,a specificity of 0. 91（ 95% CI： 0. 89-0. 92）,and a DOR of 67. 18（ 95% CI： 30. 03-150. 31）. The areas under the receiver operating characteristic curve for these three groups were 0. 914 7,0. 922 3,and 0. 952 0,respectively. Conclusion SWE has a high diagnostic value in evaluating the classification of liver fibrosis and can be used to determine liver fibrosis stage in clinical practice.