Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: Meta-analysis of prospective studies
Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: Meta-analysis of prospective studies
复制标题
DOI：
10.1148/radiol.2471070611
复制
发表时间：
2008-04-01
期刊：
影响因子：
19.7
通讯作者：
Stoker, Jaap
中科院分区：
文献类型：
--
作者：
Horsthuis, Karin;Bipat, Shandra;Stoker, Jaap
目的：通过Meta分析，比较超声(US)、磁共振(MR)成像、核素扫描、计算机断层扫描(CT)和正电子发射断层扫描(PET)在炎症性肠病(IBD)诊断中的准确性。材料和方法：检索Medline、EMBASE、CINAHL和Cochrane数据库，研究US、MR成像、闪烁成像、CT和PET在IBD诊断中的准确性，并与预先定义的参考标准进行比较。使用双变量随机效应模型计算了每个患者和每个肠段的敏感度和特异度。结果：33项研究进入了最终分析，共检索到1406篇文章。平均每个患者诊断IBD的灵敏度估计很高，并且在不同的成像方式之间没有显著差异(US、MR成像、核素扫描和CT分别为89.7%、93.0%、87.8%和84.3%)。平均每个患者的特异度估计US为95.6%，MR成像为92.8%，核素扫描为84.5%，CT为95.1%；唯一显著的差异是核素扫描和US之间的差异(P=0.009)。平均每个肠段的敏感性估计较低：US为73.5%，MR成像为70.4%，核素扫描为77.3%，CT为67.4%。平均每个肠段的特异度评估US为92.9%，MR成像为94.0%，核素扫描为90.3%，CT为90.2%。CT的敏感性和特异性明显低于核素扫描(P=0.006)和磁共振成像(P=0.037)。结论：不同的成像技术在诊断准确率上无显著差异。由于IBD患者通常需要频繁地重新评估疾病状态，因此最好使用不涉及使用电离辐射的诊断方法。(C)RSNA，2008年。
Purpose: To compare, by performing a meta-analysis, the accuracies of ultrasonography (US), magnetic resonance (MR) imaging, scintigraphy, computed tomography (CT), and positron emission tomography (PET) in the diagnosis of inflammatory bowel disease (IBD).Materials and Methods: MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched for studies on the accuracy of US, MR imaging, scintigraphy, CT, and PET, as compared with a predefined reference standard, in the diagnosis of IBD. Sensitivity and specificity estimates were calculated on per-patient and per-bowel-segment bases by using a bivariate random-effects model.Results: Thirty-three studies, from a search that yielded 1406 articles, were included in the final analysis. Mean sensitivity estimates for the diagnosis of IBD on a per-patient basis were high and not significantly different among the imaging modalities (89.7%, 93.0%, 87.8%, and 84.3% for US, MR imaging, scintigraphy, and CT, respectively). Mean per-patient specificity estimates were 95.6% for US, 92.8% for MR imaging, 84.5% for scintigraphy, and 95.1% for CT; the only significant difference in values was that between scintigraphy and US (P = .009). Mean per-bowel-segment sensitivity estimates were lower: 73.5% for US, 70.4% for MR imaging, 77.3% for scintigraphy, and 67.4% for CT. Mean per-bowel-segment specificity estimates were 92.9% for US, 94.0% for MR imaging, 90.3% for scintigraphy, and 90.2% for CT. CT proved to be significantly less sensitive and specific compared with scintigraphy (P = .006) and MR imaging (P = .037)Conclusion: No significant differences in diagnostic accuracy among the imaging techniques were observed. Because patients with IBD often need frequent reevaluation of disease status, use of a diagnostic modality that does not involve the use of ionizing radiation is preferable. (c) RSNA, 2008.