【摘要】：目的:采用Meta分析方法探討磁共振彈性成像(MRE)對肝纖維化分級的診斷效能及臨床應用價值,為臨床對肝纖維化的治療提供依據(jù)。方法:搜索2017年2月2日前國內(nèi)外公開發(fā)表的MRE診斷肝纖維化分級的中文和英文文獻。納入數(shù)據(jù)庫包括PubMed、EMBase、Web of Science、Cochrane Library、中國知網(wǎng)、中國生物醫(yī)學文獻數(shù)據(jù)庫、維普數(shù)據(jù)庫和萬方數(shù)據(jù)庫,并輔以手工檢索,按照預先納入及排除標準進行篩選,提取資料,采據(jù)QUADAS-2工具進行文獻質(zhì)量評價,采用Stata軟件分別對F0 vs F1-F4組、F0-F1 vs F2-F4組、F0-F2 vs F3-F4組和F0-F3 vs F4組MRE對肝纖維化分期診斷的敏感度(SEN)、特異度(SPE)、診斷比值比(DOR)、陽性似然比(+LR)和陰性似然比(-LR)進行合并計算及異質(zhì)性檢驗,繪制分層綜合受試者工作特征曲線(HSROC),計算曲線下面積(AUROC)。結(jié)果:共檢索出1 332篇文獻,最后納入22篇,其中英文21篇,中文1篇。Meta分析,SEN合并、SPE合并、+LR合并、-LR合并、DOR合并和AUROC,F0 vs F1-F4組分別為88.8%(85.0%~91.7%)、95.9%(91.5%~98.0%)、21.435(10.215~44.979)、0.117(0.086~0.159)、183.187(72.533~462.650)和0.96(0.94~0.98),F0-F1 vs F2-F4組分別為93.3%(89.2%~35.9%)、94.1%(90.2%~96.5%)、15.839(9.344~26.848)、0.072(0.044~0.117)、221.224(100.980~484.648)和0.98(0.96~0.99),F0-F2 vs F3-F4組分別為92.9%(88.9%~95.5%)、94.6%(91.2%~96.8%)、17.348(10.496~28.671)、0.075(0.048~0.119)、230.434(111.482~476.317)和0.98(0.96~0.99),F0-F3 vs F4組分別為97.7%(93.0%~99.3%)、93.2%(90.3%~95.2%)、14.337(9.910~20.742)、0.025(0.008~0.075)、580.405(144.871~2 325.307)和0.98(0.96~0.99)。結(jié)論:MRE作為一種新型和無創(chuàng)的影像檢查手段,對不同分期肝纖維化均具有較高診斷價值,可為臨床肝纖維化的精準治療提供可靠參考。
[Abstract]:Objective: to investigate the diagnostic efficacy and clinical application value of magnetic resonance elastography (MRE) in the classification of hepatic fibrosis by Meta analysis, so as to provide the basis for clinical treatment of hepatic fibrosis. Methods: Chinese and English literatures on MRE diagnosis of hepatic fibrosis were published at home and abroad before February 2, 2017. Included in the database are PubMeden's EMBaseof Science of Science Cochrane Library, China KnowledgeNet, Chinese Biomedical Literature Database, Weip Database and Wanfang Database, supplemented by manual retrieval, screening according to pre-inclusion and exclusion criteria, and extracting data. According to the QUADAS-2 tool to evaluate the literature quality, The sensitivity of MRE in F0 vs F1-F4 group, F0-F1 vs F2-F4 group, F0-F2 vs F3-F4 group and F0-F3 vs F4 group in the diagnosis of hepatic fibrosis staging was evaluated by Stata software. The ratio of (SEN), specificity to (SPE), was higher than that of (DOR), positive likelihood ratio (LR) and negative likelihood ratio (-LR). Drawing stratified synthetic subjects' operating characteristic Curve (HSROC), to calculate area (AUROC). Under Curve Results: a total of 1 332 articles were retrieved, and 22 articles were included, of which 21 were in Chinese and English. 涓枃1綃，

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