低剂量CT与常规剂量CT对急性阑尾炎诊断的meta分析

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

目的:采用Meta分析方法评估低剂量CT在诊断急性阑尾炎中的价值。方法:检索Pubmed、EMbase、The Cochrane Library等数据库,收集低剂量CT、常规剂量CT与阑尾炎手术病理对照结果的研究试验,检索时间截止2018年9月。按照纳入和排除标准筛选文章并提取数据,采用Meta-Disc1.4和Rev-Man5.3进行Meta分析。结果:15个实验研究共有2159个病人纳入Meta分析中,低剂量CT的敏感性和特异性分别为:0.93[95%CI(0.90~0.95)],0.92[95%CI(0.90~0.94)];常规剂量CT的敏感性和特异性分别为0.94[95%CI(0.91~0.96)]、0.94[95%CI(0.92~0.96)]。低剂量CT和常规剂量CT在急性阑尾炎诊断中无明显差异。结论:低剂量CT在急性阑尾炎中具有重要的诊断价值。

Objective To evaluate the diagnostic value of low dose CT in diagnosis of the acute appendicitis by Meta-analysis.Methods The pubmed,EMbase,Cochrane Library and other databases were searched.We collected the researchs on the comparison of acute appendicitis between low-dose CT,standard dose CT and surgical pathology results.The retrieval time was up to September 2018.According to inclusion and exclusion criteria,articles were screened and data were extracted.Meta-Disc 1.4 and Rev-Man 5.3 were used for meta-analysis.Results A total of 15 studies(2159 patients)were included.The sensitivity and specificity of low-dose CT were 0.93[95%CI(0.90~0.95)],0.92[95%CI(0.90~0.94)],respectively,the area under the receiver operating characteristic curve(ROC)was 0.97;The sensitivity and specificity of conventional-dose CT were 0.94[95%CI(0.91~0.96)]and 0.94[95%CI(0.92~0.96)].There was no significant difference between low-dose CT and conventional CT in the diagnosis of acute appendicitis.Conclusion Low-dose CT has a great value in the diagnosis of acute appendicitis.