中国循证医学杂志

中国循证医学杂志

磁共振成像诊断髋臼唇撕裂价值的 Meta 分析

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目的 系统评价磁共振成像诊断髋臼唇撕裂的价值。 方法 计算机检索 CBM、CNKI、VIP、WanFang Data、PubMed、EMbase、The Cochrane Library 和 Web of Science 数据库,搜集磁共振成像诊断髋臼唇撕裂的诊断性试验,检索时限为 1990 年 1 月至 2016 年 10 月。由 2 位研究者按纳入与排除标准独立筛选文献、提取资料和利用 QUADAS-2 工具评价纳入研究的偏倚风险后,采用 Stata 12.0 软件进行 Meta 分析,计算合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比,绘制受试者工作特征曲线(SROC 曲线)并计算曲线下面积(AUC)。 结果 最终纳入 21 篇文献的 25 个研究,包括 1 099 例患者和 1 123 个髋关节。Meta 分析结果显示,磁共振平扫诊断髋臼唇撕裂的 Sen合并=0.66[95% CI(0.38,0.86)]、Spe合并=0.72[95% CI(0.47,0.89)]、+LR合并=2.37[95% CI(1.18,4.76)]、–LR合并=0.48[95% CI(0.25,0.92)]、DOR合并=4.97[95% CI(1.60,15.47)]、AUC=0.75[95% CI(0.71,0.79)]。磁共振髋关节造影诊断髋臼唇撕裂的 Sen合并=0.86[95% CI(0.80,0.90)]、Spe合并=0.71[95% CI(0.55,0.83)]、+LR合并=2.91[95% CI(1.77,4.80)]、–LR合并=0.20[95% CI(0.13,0.32)]、DOR合并=14.44[95% CI(5.80,35.95)]、AUC=0.87[95% CI(0.84,0.90)]。 结论 磁共振成像对诊断髋臼唇撕裂具有明确的诊断价值,使用磁共振髋关节造影的病例具备更高的诊断效能。

Objective To evaluate the values of magnetic resonance imaging (MRI) in the diagnosis of acetabular labral tears (ALT) by meta-analysis. Methods The studies concerning the diagnosis of ALT tears by using MRI from January 1990 to October 2016 were searched in the databases such as CBM, VIP, WanFang Data, CNKI, PubMed, EMbase, The Cochrane Library and Web of Science. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then, meta-analysis was performed by using Stata 12.0 software. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (–LR) and the diagnostic odds ratio (DOR) were calculated, and the summary receiver operating characteristic curve (SROC) was drawn and the area under the carve was calculated. Results A total of 25 studies from 21 articles were included, involving 1 123 hips from 1 099 patients. The results of meta-analysis showed that, the pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRI for diagnosing ALT were 0.66 (95% CI 0.38 to 0.86), 0.72 (95% CI 0.47 to 0.89), 2.37 (95% CI 1.18 to 4.67), 0.48 (95% CI 0.25 to 0.92), 4.97 (95% CI 1.60 to 15.47), 0.75 (95% CI 0.71 to 0.79). The pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRA for diagnosing ALT were 0.86 (95% CI 0.80 to 0.90), 0.71 (95% CI 0.55 to 0.83), 2.91 (95% CI 1.77 to 4.80), 0.20 (95% CI 0.13 to 0.32), 14.44 (95% CI 5.80 to 35.95), 0.87 (95% CI 0.84 to 0.90), respectively. Conclusion MRI is efficiency diagnostic method for acetabular labral tears.

关键词: 磁共振成像; 磁共振髋关节造影; 髋关节; 臼唇; 损伤; Meta 分析

Key words: Magnetic resonance imaging; Magnetic resonance artlrography; Hip joint; Labrum; Damage; Diagnosis; Meta-analysis

引用本文: 许永生, 刘海峰, 王寅中, 高玉岭, 田水水, 田金徽, 杨克虎, 雷军强. 磁共振成像诊断髋臼唇撕裂价值的 Meta 分析. 中国循证医学杂志, 2017, 17(3): 291-297. doi: 10.7507/1672-2531.201611079 复制

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