动态增强MRI对乳腺病变鉴别诊断的meta分析

摘要

Objective To assessed the value of DCE -MRI in differentiation of benign and malignant breast lesions using a me-ta -analysis method.Method Articles published in Chinese were retrieved and selected in CNKI(China National Knowledge Infra-structure),Wanfang and CMB database.Statistical analysis was performed by Meta -DiSc1.4.Diagnostic effectiveness of DCE -MRI differentiation of benign and malignant breast lesions was evaluated by calculated the AUC of the SROC and pooled the sensi-tivity and the specificity one by one.Results 30 independent articles eventually included in this Meta -analysis,26 of 30 articles were evaluated for the value of the type of TIC in differentiation of benign and malignant breast lesions,23 of 30 were analyzed for the value of morphology.The pooled weighted sensitivity and specificity and AUC of SROC curve of TIC in differentiation of benign and malignant breast was 0.83(95% CI:0.80 ~0.86),0.72(95%CI:0.69 ~0.76),89.18%,respectively;morphology was 0.89 (95%CI:0.86 ~0.91),0.73(95%CI:0.70 ~0.76,88.93%,respectively.Conclusion There are high sensitivity and moderate specificity for DCE -MRI in differentiation of benign and malignant breast lesions,however,a large sample further study is needed.%目的：Meta 分析动态增强 MRI（DCE －MRI）对鉴别乳腺良恶性病变的准确性。方法：检索 CNKI、万方数据、CBM数据库有关 DCE －MRI 鉴别乳腺良恶性病变的中文文献，并采用 Meta －disc1.4软件进行汇总分析。结果：共30篇文献符合标准，提取 DCE －MRI 增强后形态学、TIC 类型进行综合研究，则其形态学、TIC 类型对乳腺良恶性疾病诊断的敏感度及95％的可信区间分别为0.83（95％ CI：0.80～0.86）、0.89（95％ CI：0.86～0.91），特异度及95％的可信区间为0.72（95％ CI：0.69～0.76）、0.73（95％ CI：0.70～0.76）；SROC 曲线下面积分别为89.18％及88.93％。结论：DCE－MRI 有助于乳腺病变的良恶性鉴别诊断敏感性较高，但特异性一般，其对乳腺良恶性病变诊断具有一定的价值，但是DCE －MRI 特征有重叠，仍需大样本的研究证实。