磁共振扩散加权成像鉴别诊断胆囊良恶性病变的Meta分析
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Cite this article as: Zhang XX, Luo YL, Zhang H, et al. Diagnostic performance of diffusion weighted imaging for differentiating benign and malignant gallbladder lesions: a Meta-analysis. Chin J Magn Reson Imaging, 2019, 10(9): 674-679. 本文引用格式：张旭霞, 骆伊丽, 张皓, 等. 磁共振扩散加权成像鉴别诊断胆 囊良恶性病变的Meta分析. 磁共振成 像, 2019, 10(9): 674-679.
临床研究 | Clinical Articles
磁共振成像 2019年第10卷第9期 Chin J Magn Reson Imaging, 2019, Vol 10, No 9
磁共振扩散加权成像鉴别诊断胆囊良恶性 病变的Meta分析
张旭霞1，2，骆伊丽1，2，张皓2*，许永生1，2，岳梦颖1，2，孙碧霞1，2，鲁忠燕1，2
作者单位： 1. 兰州大学第一临床医学院，兰州 730000 2. 兰州大学第一医院放射科，兰州 730000
通信作者： 张皓，E-mail：zhanghao@
收稿日期：2019-01-03 接受日期：2019-05-18
中图分类号：R445.2；R735.8 文献标识码：A DOI: 10.12015/issn.1674-8034.2019.09.007
Diagnostic performance of diffusion weighted imaging for differentiating benign and malignant gallbladder lesions: a Meta-analysis
ZHANG Xuxia1, 2, LUO Yili1, 2, ZHANG Hao2*, XU Yongsheng1, 2, YUE Mengying1, 2, SUN Bixia1, 2, Clinical Medical College of Lanzhou University, Lanzhou 730000, China 2Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China *Correspondence to: Zhang H, E-mail: zhanghao@ Received 3 Jan 2019, Accepted 18 May 2019
Abstract Objective: To evaluate the diagnostic value of diffusion weighted magnetic resonance imaging in patients with gallbladder lesions by Meta-analysis. Materials and Methods: Based on validity criteria for diagnostic research published by PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang Data, CBM and VIPfrom inception to December 2018, to search the differentiation of gallbladder lesions with diffusion weighted imaging (DWI) . Two investigators independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 tool and Review Manager 5.3, and then Meta-analysis was conducted using Stata 12.0 software. Results: A total of 13 articles were included (8 English, 5 Chinese). The results of Meta-analysis showed that, the pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) of DWI for differentiating benign and malignant gallbladder lesions were 0.88(95%CI, 0.78—0.94), 0.85(95%CI, 0.79—0.89), 5.84(95%CI, 3.97—8.59), 0.14(95%CI, 0.07—0.28), 41.88 (95%CI, 15.42—113.69), and the area under summary receiver operating characteristic (SROC) curve of DWI for differentiating benign and malignant gallbladder lesions is 0.93, Q*=0.86. The pooled Sen, Spe, +LR, -LR, DOR of apparent diffusion coefficient (ADC) for differentiating benign and malignant gallbladder lesions were 0.79(95%CI, 0.71—0.86), 0.93(95%CI, 0.83— 0.97), 10.8(95%CI, 4.7—25.1), 0.22(95%CI, 0.16—0.32), 48(95%CI, 18—127), and the area under SROC curve of ADC for differentiating benign and malignant gallbladder lesions is 0.89, Q*=0.82 respectively. Conclusions: Diffusion weighted magnetic resonance imaging is of great accuracy in differentiating benign and malignant gallbladder lesions. Key words gallbladder neoplasms; gallbladder diseases; magnetic resonance imaging;
[摘要] 目的 对磁共振扩散加权成像鉴别诊断胆囊良恶性病变的价值进行Meta分析。 材料与方法 检索自建库起至2018年12月1日PubMed、EMbase、Web of Science、The Cochrane Library、CNKI、万方数据库、中国生物医学文献数据库、中国科技期刊数 据库中有关磁共振扩散加权成像鉴别诊断胆囊良恶性病变的相关文献。2名研究者分别 按照所制定的纳入标准以及排除标准独立筛选文献、提取数据并运用QUADAS-2文献 质量评价工具及Review Manager 5.3软件评价纳入文献的偏倚风险，采用Stata 12.0软件 进行Meta分析。结果 最终纳入13篇文献，其中英文8篇，中文5篇，Meta分析结果显 示，扩散加权成像(diffusion weighted imaging，DWI)鉴别胆囊良恶性病变的合并敏感 度(Sen合并)为0.88 (95%CI，0.78～0.94)、特异度(Spe合并)为0.85 (95%CI，0.79～0.89)、 阳性似然比(+LR合并)为5.84(95%CI，3.97～8.59)、阴性似然比(-LR合并)为0.14 (95%CI， 0.07～0.28)、诊断比值比(DOR合并)为41.88 (95%CI，15.42～113.69)；汇总受试者工作 特征(summary receiver operating characteristic，SROC)曲线下面积为0.93，Q*为0.86。 表观扩散系数(apparent diffusion coefficient，ADC)鉴别胆囊良恶性病变的Sen合并为0.79 (95%CI，0.71～0.86)、Spe合并为0.93 (95%CI，0.83～0.97)、+LR合并为10.8 (95%CI， 4.7～25.1)、-LR合并为0.22 (95%CI，0.16～0.32)、DOR合并为48 (95%CI，18～127)； SROC曲线下面积为0.89，Q*为0.82。结论 磁共振扩散加权成像对胆囊良恶性病变的 鉴别具有较高诊断价值。 [关键词] 胆囊肿瘤；胆囊疾病；磁共振成像；诊断，鉴别；基于文献的发现
临床研究 | Clinical Articles
磁共振成像 2019年第10卷第9期 Chin J Magn Reson Imaging, 2019, Vol 10, No 9
磁共振扩散加权成像鉴别诊断胆囊良恶性 病变的Meta分析
张旭霞1，2，骆伊丽1，2，张皓2*，许永生1，2，岳梦颖1，2，孙碧霞1，2，鲁忠燕1，2
作者单位： 1. 兰州大学第一临床医学院，兰州 730000 2. 兰州大学第一医院放射科，兰州 730000
通信作者： 张皓，E-mail：zhanghao@
收稿日期：2019-01-03 接受日期：2019-05-18
中图分类号：R445.2；R735.8 文献标识码：A DOI: 10.12015/issn.1674-8034.2019.09.007
Diagnostic performance of diffusion weighted imaging for differentiating benign and malignant gallbladder lesions: a Meta-analysis
ZHANG Xuxia1, 2, LUO Yili1, 2, ZHANG Hao2*, XU Yongsheng1, 2, YUE Mengying1, 2, SUN Bixia1, 2, Clinical Medical College of Lanzhou University, Lanzhou 730000, China 2Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China *Correspondence to: Zhang H, E-mail: zhanghao@ Received 3 Jan 2019, Accepted 18 May 2019
Abstract Objective: To evaluate the diagnostic value of diffusion weighted magnetic resonance imaging in patients with gallbladder lesions by Meta-analysis. Materials and Methods: Based on validity criteria for diagnostic research published by PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang Data, CBM and VIPfrom inception to December 2018, to search the differentiation of gallbladder lesions with diffusion weighted imaging (DWI) . Two investigators independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 tool and Review Manager 5.3, and then Meta-analysis was conducted using Stata 12.0 software. Results: A total of 13 articles were included (8 English, 5 Chinese). The results of Meta-analysis showed that, the pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) of DWI for differentiating benign and malignant gallbladder lesions were 0.88(95%CI, 0.78—0.94), 0.85(95%CI, 0.79—0.89), 5.84(95%CI, 3.97—8.59), 0.14(95%CI, 0.07—0.28), 41.88 (95%CI, 15.42—113.69), and the area under summary receiver operating characteristic (SROC) curve of DWI for differentiating benign and malignant gallbladder lesions is 0.93, Q*=0.86. The pooled Sen, Spe, +LR, -LR, DOR of apparent diffusion coefficient (ADC) for differentiating benign and malignant gallbladder lesions were 0.79(95%CI, 0.71—0.86), 0.93(95%CI, 0.83— 0.97), 10.8(95%CI, 4.7—25.1), 0.22(95%CI, 0.16—0.32), 48(95%CI, 18—127), and the area under SROC curve of ADC for differentiating benign and malignant gallbladder lesions is 0.89, Q*=0.82 respectively. Conclusions: Diffusion weighted magnetic resonance imaging is of great accuracy in differentiating benign and malignant gallbladder lesions. Key words gallbladder neoplasms; gallbladder diseases; magnetic resonance imaging;
[摘要] 目的 对磁共振扩散加权成像鉴别诊断胆囊良恶性病变的价值进行Meta分析。 材料与方法 检索自建库起至2018年12月1日PubMed、EMbase、Web of Science、The Cochrane Library、CNKI、万方数据库、中国生物医学文献数据库、中国科技期刊数 据库中有关磁共振扩散加权成像鉴别诊断胆囊良恶性病变的相关文献。2名研究者分别 按照所制定的纳入标准以及排除标准独立筛选文献、提取数据并运用QUADAS-2文献 质量评价工具及Review Manager 5.3软件评价纳入文献的偏倚风险，采用Stata 12.0软件 进行Meta分析。结果 最终纳入13篇文献，其中英文8篇，中文5篇，Meta分析结果显 示，扩散加权成像(diffusion weighted imaging，DWI)鉴别胆囊良恶性病变的合并敏感 度(Sen合并)为0.88 (95%CI，0.78～0.94)、特异度(Spe合并)为0.85 (95%CI，0.79～0.89)、 阳性似然比(+LR合并)为5.84(95%CI，3.97～8.59)、阴性似然比(-LR合并)为0.14 (95%CI， 0.07～0.28)、诊断比值比(DOR合并)为41.88 (95%CI，15.42～113.69)；汇总受试者工作 特征(summary receiver operating characteristic，SROC)曲线下面积为0.93，Q*为0.86。 表观扩散系数(apparent diffusion coefficient，ADC)鉴别胆囊良恶性病变的Sen合并为0.79 (95%CI，0.71～0.86)、Spe合并为0.93 (95%CI，0.83～0.97)、+LR合并为10.8 (95%CI， 4.7～25.1)、-LR合并为0.22 (95%CI，0.16～0.32)、DOR合并为48 (95%CI，18～127)； SROC曲线下面积为0.89，Q*为0.82。结论 磁共振扩散加权成像对胆囊良恶性病变的 鉴别具有较高诊断价值。 [关键词] 胆囊肿瘤；胆囊疾病；磁共振成像；诊断，鉴别；基于文献的发现