低剂量CT诊断急性阑尾炎的Meta分析

Meta-analysis of low dose CT in the diagnosis of acute appendicitis

目的采用Meta分析方法评价低剂量CT对急性阑尾炎的诊断价值。方法计算机检索Pub Med、EMbase、The Cochrane Library、CBM、CNKI、Wan Fang Data和VIP等数据库,收集有关低剂量CT与手术病理结果比较对急性阑尾炎的诊断性试验,所有文献均检索截至2018年1月。按照纳入与排除标准筛选文献、提取资料和评价质量后,采用Meta-Di Sc 1.4和Rev-Man 5.3软件进行Meta分析。结果最终共纳入11个研究,1 428例患者。Meta分析结果显示,以手术病理结果为标准,低剂量CT对急性阑尾炎的诊断效能:敏感度合并为0.94[95%CI(0.92~0.95)],特异度合度为0.93[95%CI(0.91~0.95)],阳性似然比合并为13.21[95%CI(9.98~17.49)],阴性似然比合并为0.07[95%CI(0.05~0.12)],受试者工作特征曲线下面积为0.9718。结论低剂量CT对急性阑尾炎具有重要的诊断价值。

Objective To evaluate the diagnostic value of low dose CT in acute appendicitis by Meta-analysis. Methods The data bases such as Pub Med,Embase,The cochrane Library,CBM,CNKI,Wan Fang Data and VIP were searched to collect diagnostic tests on the comparison of acute appendicitis between low-dose CT and surgical pathology results. All literatures retrievaled as of January 2018. After the literatures were screened based on inclusion and exclusion criteria,extracted and evaluated,the Meta-analysis was performed using Meta-Di Sc 1. 4 and Rev-Man 5. 3 software. Results A total of 11 studies（ 1 428 patients） were included. Based on the results of surgical pathology,Meta-analysis showed that in the diagnosis of acute appendicitis by low dose CT,the sensitivity weighted was 0. 94[95% CI（ 0. 92-0. 95） ],the specificity weighted was 0. 93[95% CI（ 0. 91-0. 95） ],the weighted positive likelihood ratio was 13. 21[95% CI（ 9. 98-17. 49） ],the weighted negative likelihood ratio was 0. 07[95% CI（ 0. 05-0. 12） ] and the area under the receiver operating characteristic curve（ ROC） was 0. 9718. Conclusion Low-dose CT has an important value in the diagnosis of acute appendicitis.