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目的系统评价磁共振全身弥散加权成像(WB-DWI)诊断骨转移瘤的准确性。方法检索PubMed、EMBASE、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、万方数据、维普资讯相关文献,按照纳入标准筛选关于磁共振WB-DWI对骨转移瘤诊断的研究,检索时间均由1995年1月至2013年9月。采用Meta-disc 1.4软件检验研究间的异质性,对诊断符合率进行Meta分析,并进行综合受试者工作特征(SROC)分析。结果共纳入8篇符合标准的文章,磁共振WB-DWI对骨转移瘤诊断的敏感度为0.92(95%CI:0.90~0.93),特异度为0.94(95%CI:0.92~0.95),阳性似然比为13.48(95%CI:8.2~22.15),阴性似然比为0.09(95%CI:0.07~0.12),诊断优势比为122.60(95%CI:84.92~176.99)。SROC曲线下面积为0.9678。结论磁共振WB-DWI诊断骨转移瘤具有较高的敏感性和特异性,但仍需大样本的研究进一步加以证实。
Objective To systematically evaluate the accuracy of magnetic resonance whole body diffusion-weighted imaging (WB-DWI) in the diagnosis of bone metastases. Methods We searched PubMed, EMBASE, Cochrane Library, China Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Data and VIP Information for screening of bone metastases by WB-DWI according to the inclusion criteria From January 1995 to September 2013. Meta-disc 1.4 software was used to examine the heterogeneity among the studies. Meta-analysis was performed on the diagnostic coincidence rate and the SROC analysis was performed. Results A total of eight articles were included. The sensitivity of WB-DWI in diagnosis of bone metastases was 0.92 (95% CI: 0.90-0.93) and specificity was 0.94 (95% CI: 0.92-0.95) The likelihood ratio was 13.48 (95% CI: 8.2-22.15) and the negative likelihood ratio was 0.09 (95% CI: 0.07-0.12). The odds ratio for diagnosis was 122.60 (95% CI: 84.92-176.99). The area under the SROC curve is 0.9678. Conclusion Magnetic resonance imaging of bone metastases with WB-DWI has high sensitivity and specificity, but still need to be further confirmed by large sample studies.