扩散张量成像对脊髓型颈椎病预测价值的Meta分析

Meta-analysis of the predictive value of diffusion tensor imaging in cervical spondylotic myelopathy

目的系统评价扩散张量成像(DTI)常用变量各向异性参数(FA)和表观扩散系数(ADC)对脊髓型颈椎病(CSM)的预测价值。方法在PubMed、Cochrane Library、EMBASE、Web of Science和万方数据库中检索2000~2021年CSM患者与健康对照者的DTI队列研究,采用改良纽卡斯尔-渥太华量表(NOS)对纳入文献进行质量评估,采用STATA14.0软件进行连续性变量资料的Meta分析。结果最终纳入10篇文献,共有327例CSM患者和208名健康对照者,在FA值的比较中,CSM患者组282例,健康对照组199例,CSM患者中最大受压水平(LMC)比健康对照组的FA低,差异具有统计学意义(SMD=-2.32,95%CI:-2.56~-2.06,P<0.001);在ADC值的比较中,CSM患者组177例,健康对照组132例,CSM患者组中LMC比健康对照组的ADC高,差异具有统计学意义(SMD=1.95,95%CI:1.67~2.23,P<0.001)。结论作为DTI参数的FA值和ADC值具有成为预测CSM的潜在能力,DTI有很大的可能成为诊断CSM的一个重要组成部分。

Objective To systematically evaluate the predictive value of the anisotropy parameter(FA)and the apparent diffusion coefficient(ADC)of the common variables of diffusion tensor imaging(DTI)for cervical spondylotic myelopathy(CSM).Methods DTI cohort studies of CSM patients and healthy controls were retrieved from PubMed,Cochrane Library,Embase,Web of Science and Wanfang database from 2000 to 2021.The modified Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included literature.The Meta-analysis of continuous variable data was performed using Stata 14.0 software.Results A total of 10 studies were included,including 327 patients with CSM and 208 healthy controls.In the comparison of FA values,there were 282 patients in the CSM group and 199 healthy controls.The Level of maximal cord compression LMC in CSM patients was lower than that in healthy controls,and the results were statistically significant(SMD=-2.32,95%CI:-2.56--2.06,P<0.001).In the comparison of ADC values,there were 177 patients in the CSM group and 132 in the healthy control group.The LMC in the CSM group was higher than that in the healthy control group,and the results were statistically significant(SMD=1.95,95%CI:1.67-2.23,P<0.001).Conclusion As DTI parameters,FA value and ADC value have potential ability to predict CSM,and DTI may be an important part in the diagnosis of CSM.