剪切波弹性成像诊断胆道闭锁价值的Meta分析

Application of shear wave elastography for diagnosing biliary atresia:a Meta-analysis

目的对近年来公开报道的应用剪切波弹性成像诊断胆道闭锁的相关研究做一荟萃分析,初步评估剪切波弹性成像在诊断胆道闭锁中的价值。方法根据检索式对中英文数据库文献进行检索,按研究纳入排除标准筛选文献,并使用QUADAS-2量表对纳入文献的质量进行评价。提取文献数据,拟合SROC曲线。结果本荟萃分析共检索到相关文献132篇,按纳入与排除标准,最终纳入数据分析的研究共7项,结果提示剪切波弹性成像诊断胆道闭锁拟合SROC曲线下面积为0.90(95%CI:0.88~0.93),灵敏度为84%(95%CI:72%~92%),特异度为83%(95%CI:70%~91%)。结论剪切波弹性成像诊断胆道闭锁的临床应用前景可观,但目前尚缺乏前瞻性、高质量的临床诊断试验,各研究间异质性较大,其诊断价值尚有待进一步验证。儿童剪切波弹性成像检测方法目前尚没有统一标准,有待进一步探索、完善。

Objective To determine the value of shear wave elastography(SWE)in the diagnosis of biliary atresia(BA)through a meta-analysis of the relevant recent researches.Methods According to the retrieval criteria,the Chinese and English database literature was searched and the articles were screened and selected.The included literature was evaluated by the QUADAS-2 scale.The relevant data were extracted and SROC curve was plotted.Results A total of 132 relevant literatures were retrieved.Based upon the eligibility criteria,7 studies were finally included for data analysis.The results showed that the area under the SROC curve of SWE for diagnosing BA was 0.90(95%CI:0.88-0.93),the combined sensitivity 81%(95%CI:72%-92%)and the combined specificity 85%(95%CI:70%-91%).Conclusion SWE is valuable for diagnosing BA.However,there is still a lack of prospective and high-quality clinical diagnostic tests.The heterogeneity of previous studies is high so that the diagnostic value of SWE should be further verified.Meanwhile the method of SWE in children remains to be further improved and standardized.