双能量CT对椎体骨折骨髓水肿诊断准确性Meta分析

目的 对双能量CT(DECT)虚拟非钙化(VNCa)技术诊断椎体骨髓水肿的文献进行荟萃分析,评价DECT VNCa技术对椎体骨折骨髓水肿的诊断效能及其价值.方法 使用万方医药数据库、中国知网期刊数据库、Pubmed数据库检索双能量CT骨髓水肿中英文相关文献.骨髓水肿以MRI为金标准,对纳入文献进行质量评价,提取纳入研究的特征信息.数据分析采用Meta DISC1.4统计软件.检验纳入研究的异质性,绘制受试者工作特征曲线(SROC),并计算曲线下面积(AUC).结果 最后纳入符合标准的文献8篇,无异质性.计算效应合并值,DECT VNCa诊断骨髓水肿合并敏感度为0.82(95%CI:0.77~0.86);合并特异度为0.96(95%CI:0.95~0.98);合并阳性似然比为17.55(95%CI:8.56~35.96);合并阴性似然比为0.19(95%CI:0.12~0.30);合并OR值为114.51(95% CI:64.19~204.28);SROC AUC为0.9546,敏感度与特异度交点最大值(Q值)为0.8968.结论 DECT VNCa诊断骨髓水肿具有较高的准确性,可作为评价急性椎体骨折的主要检查项目之一.

Objective To perform a meta-analysis of dual energy CT virtual non calcification(VNCa)technology in diagnosis of vertebral bone marrow edema and evaluate the diagnostic efficiency and value of dual energy CT VNCa technique for bone marrow edema of vertebral body fracture. Methods The literatures of the dual energy CT bone marrow edema were retrieved using the Wanfang medical database,the Chinese knowledge network journal database,and the Pubmed database. MRI was the gold standard for bone marrow edema. The quality of included literatures was assessed. The characteristics of the included articles were appraised and extracted. Statistical analysis was performed Meta-Disc 1.4 software. Summary Receiver Operating Characteristic(SROC)curve was drawn and the area under the curve(AUC)was calculated. Results Eight studies without heterogeneity were included for analysis. The effect of the merger value calculation,DECT VNCa in diagnosis of bone marrow edema with a sensitivity of 0.82 (95%CI:0.77 to 0.86);with a specificity of 0.96(95%CI:0.95 to 0.98);and the positive likelihood ratio was 17.55(95%CI:8.56~35.96);and the negative likelihood ratio was 0.19(95%CI:0.12 to 0.30);and OR a value of 114.51(95% CI:64.19 to 204.28);the area under the SROC curve(AUC)was 0.9546. The maximum value(Q value)of sensitivity and specificity was 0.8968. Conclusion DECT VNC imaging gives very good diagnostic performance for BME detection and will likely be an common modality for acute vertebral body fracture in the future.