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目的采用Meta分析方法评价MRI扩散加权成像(DWI)的表观扩散系数(ADC)在鉴别良恶性椎体压缩骨折的诊断价值。方法通过计算机检索2000年~2015年Cochrane图书馆、Pubmed、Ovid、Elsevier、Springer数据库、中国期刊全文数据库(CNKI),搜索关于MRI DWI中应用ADC值鉴别良恶性椎体压缩骨折的中英文文献,对符合纳入条件的原始研究进行质量评价,提取纳入研究的相关信息。采用Stata/SE 12.0软件进行统计分析。结果符合纳入标准的文献共15篇,研究病灶椎体共计804节,其中恶性椎体压缩骨折椎体424节,良性椎体压缩骨折椎体380节。应用Q检验和I2进行异质性检验,对结果进行异质性分析发现文献存在异质性,采用随机效应模型分析,恶性椎体压缩骨折的ADC值明显低于良性椎体压缩骨折[均数标准差(SMD)=-2.407,95%可信区间(CI)=-2.955~-1.860,P=0.000]。结论DWI-ADC值有助于良恶性椎体压缩骨折的鉴别。
Objective To evaluate the diagnostic value of apparent diffusion coefficient (ADC) of MRI diffusion-weighted imaging (DWI) in differential diagnosis of benign and malignant vertebral compression fractures by Meta analysis. Methods The Cochrane Library, Pubmed, Ovid, Elsevier, Springer database and CNKI were searched by computer. The Chinese and English documents on MRI DWI for the identification of benign and malignant vertebral compression fractures were searched. The quality of the original studies that meet the inclusion criteria is evaluated and the relevant information included in the study is extracted. Stata / SE 12.0 software for statistical analysis. Results A total of 15 literatures were included in the study. The total number of vertebral lesions was 804, including 424 vertebral bodies of malignant vertebral compression fractures and 380 vertebral bodies of benign vertebral compression fractures. Heterogeneity test using Q test and I2, heterogeneity analysis of the results found heterogeneity in the literature, the use of random effects model analysis, malignant vertebral compression fracture ADC value was significantly lower than that of benign vertebral compression fractures [means Standard deviation (SMD) = -2.407, 95% confidence interval (CI) = -2.9550-1.860, P = 0.000]. Conclusion DWI-ADC value is helpful to differentiate benign and malignant vertebral compression fractures.