磁共振灌注成像诊断缺血性心脏病的Meta分析

Meta-analysis of MR Perfusion Imaging Diagnosis of Ischemic Heart Disease

目的综合评价磁共振灌注成像诊断缺血性心脏病的诊断价值。方法检索Pub Med、Cochrane Library、中国生物文献数据库、中国期刊全文数据库、维普资讯、万方数据等数据库的相关文献,按照纳入标准筛选关于磁共振灌注成像对缺血性心脏病的研究,检索时间为1995-01—2016-10间。采用Meta-disc 1.4系统分析纳入文献的异质性,对诊断效率进行Meta分析,并绘制受试者工作特征曲线进行分析。结果共纳入8篇符合标准的文章,磁共振灌注成像诊断缺血性心脏病的合并敏感度为0.89(95%CI:0.83~0.93),合并特异度为0.88(95%CI:0.82~0.92),合并阳性似然比为6.79(95%CI:4.63~9.98),合并阴性似然比0.15(95%CI:0.09~0.22),合并诊断优势比为52.29(95%CI:27.16~100.70)。受试者工作曲线下面积的数值为0.9384。结论磁共振灌注成像诊断缺血性心脏病具有较高的诊断价值,但是需要更大样本量的研究加以证明。

Objective To sysematically evalue the diagnositic accuracy of MR perfusion imaging for ischemic heart disease through using Meta-analysis.Methods Pubmed,Cochrane Library,Chinese Biomedical Literature Database,China Journal Fulltext Database,VIP Chinese Science and Technology Periodical Database and Wanfang Digital Periodical Datbase were retrieved.The diagnostic studies about MR perfusion imaging for ischemic heart disease were screened according to the inclusion criteria.The retrieval time was from January,1995 to October,2016.Data on accuracy of included studies were extracted for further heterogeneity exploring,statistical pooling and SROC（summary receiver operating characteristics） analyzing through using the Meta-disc 1.4 software.Results Totally 8 studies met the inclusion criteria.The results of the Meta analysis showed that the pooled sensitivity of the diagnosis of MR perfusion imaging for ischemic heart disease was 0.89（95% CI： 0.83 ~ 0.93）,the pooled specificity was 0.88（95% CI：0.82 ~ 0.92）,the pooled positive likelihood ratio was 6.79（95% CI： 4.63 ~ 9.98）,the pooled negative likelihood ratio was 0.15（95% CI： 0.09 ~ 0.22）,the pooled OR was 52.29（95% CI： 27.16 ~ 100.70）,and the pooled SROC area under the curve was0.9384.Conclusion There is high value for ischemic heart disease of MR perfusion imaging,however,a large sample study still needs to be confirmed by further study.