Meta-analysis of quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesions.
Meta-analysis of quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesions.
复制标题
定量弥散加权磁共振成像在乳腺病变鉴别诊断中的Meta分析
DOI：
10.1186/1471-2407-10-693
复制
发表时间：
2010-12-29
期刊：
影响因子：
3.8
通讯作者：
Bai ZL
中科院分区：
文献类型：
--
作者：
Chen X;Li WL;Zhang YL;Wu Q;Guo YM;Bai ZL
在一项荟萃分析中，确定定量弥散加权（DW）MR成像在乳腺病变患者中的诊断性能。参考入选和排除标准，对2009年6月之前发表的评估定量DWI在乳腺病变患者中诊断性能的英文和中文研究进行了审查和总结。方法学质量采用QUADAS诊断性研究质量评价量表进行评价。采用综合荟萃分析第2版进行发表偏倚分析。使用Meta-Disc 1.4版描述初步结果，并通过卡方检验和不一致性指数探索同质性;通过受试者操作特征（ROC）空间和斯皮尔曼相关系数探索阈值效应;通过固定或随机效应模型合并加权敏感性和特异性。构建概括ROC（sROC）曲线以计算曲线下面积（AUC）。在65个合格的研究中，13个615个恶性病变和349个良性病变被纳入原始荟萃分析，其中探讨了阈值效应和发表偏倚以外的因素引起的异质性。方法学质量中等。采用最大B = 1000 s/mm 2的一个同质亚组研究中，合并加权灵敏度和特异性以及相应的95%置信区间（CI）分别为0.84（0.80，0.87）和0.84（0.79，0.88）。sROC的AUC为0.9085。敏感性分析表明，合并估计是稳定和可靠的。与增强MRI相比，定量DWI对乳腺良恶性病变的鉴别具有更高的特异性。但由于弥散梯度因子B和诊断阈值的限制，需要大规模的随机对照试验来评价其临床价值。
To determine, in a meta-analysis, the diagnostic performance of quantitative diffusion-weighted (DW) MR imaging in patients with breast lesions. English and Chinese studies published prior to June 2009 to assess the diagnostic performance of quantitative DWI in patients with breast lesions were reviewed and summarized with reference to the inclusion and exclusion criteria. Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS) instrument. Publication bias analysis was performed by using Comprehensive Meta-analysis version 2. Meta-Disc version 1.4 was used to describe primary results and explore homogeneity by Chi-square test and inconsistency index; to explore threshold effect by receiver operator characteristic (ROC) space and Spearman correlation coefficient; and to pool weighted sensitivity and specificity by fixed or random effect model. A summary ROC (sROC) curve was constructed to calculate the area under the curve (AUC). Of 65 eligible studies, 13 with 615 malignant and 349 benign lesions were included in the original meta-analysis, among which heterogeneity arising from factors other than threshold effect and publication bias was explored. Methodological quality was moderate. The pooled weighted sensitivity and specificity with corresponding 95% confidence interval (CI) in one homogenous subgroup of studies using maximum b = 1000 s/mm2 were 0.84 (0.80, 0.87) and 0.84 (0.79, 0.88) respectively. AUC of sROC was 0.9085. Sensitivity analysis demonstrated that the pooled estimates were stable and reliable. Quantitative DWI has a higher specificity to differentiate between benign and malignant breast lesions compared to that of contrast-enhanced MRI. However, large scale randomized control trials (RCTs) are necessary to assess its clinical value because of disunified diffusion gradient factor b and diagnosis threshold.
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影响因子：
--
作者：
Deeks, JJ
通讯作者：
Deeks, JJ
影响因子：
158.5
作者：
Kriege, M;Brekelmans, CTM;Klijn, JGM
通讯作者：
Klijn, JGM
影响因子：
254.7
作者：
Parkin, DM;Bray, F;Pisani, P
通讯作者：
Pisani, P
影响因子：
4.4
作者：
Guo, Y;Cai, YQ;Gao, JH
通讯作者：
Gao, JH
DOI：
10.1016/j.mric.2006.07.002
发表时间：
2006-08-01
影响因子：
1.6
作者：
Kuhl, Christiane K
通讯作者：
Kuhl, Christiane K