Objective: To summarize the accuracy of low-dose CT (LDCT) for urolithiasis with Meta-analysis. Materials and Methods: Published studies were identified by Pub/Medline and Ovid databases and Chinese databases (1990-2011) in search of LDCT studies for urolithiasis. A standard extractive database was obtained. Inclusion and exclusion criteria were used to extract relevant data. QUADAS was analyzed. Using software Excel 2003 and Metadisc 1.4, the summary sensitivity and specificity, summary positive likelihood ratio and summary negative likelihood ratio were caculated. Heterogeneity and bi-ase were also evaluated. Result: Of 264 identified studies, 9 involving studies were considered appropriate for pooled analysis. There were 1298 cases all together. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio were 0.959(95% CI: 0.944~0.972), 0.957(95% CI: 0.934~0.973), 17.853(95% CI: 11.735~27.161) and 0.045(95% CL 0.025~0.078), respectively. Conclusion: LDCT is of high specificity and sensitivity for urolithiasis. But there were biases in the studies and appropriate studies are needed.%目的:采用循证医学的Meta分析方法研究低剂量CT (Low-dose CT,LDCT)诊断的准确性.材料与方法:收集1990-2011年国内外公开发表的LDCT诊断的文献,用LDCT(全部CT检查总剂量＜3 mSy)检查泌尿系结石,并根据QUADAS质量评价标准评价文献的质量,分析偏倚和变异产生的来源,同时对文献间异质性来源进行分析,并用定量方法SROC对有阈值效应的数值进行合并,对无阈值效应的数据进行随机效应分析(有异质性)和固定效应(无异质性)分析合并.数据分析采用Excel 2003和Metadisc 1.4软件,得到合并的SROC曲线,合并的诊断敏感性和特异性,以及合并的阳性和阴性似然比.结果:共检索到文献264篇,符合纳入标准的文献共9篇,均为LDCT诊断准确性研究,共有病例数为1298例,合并敏感性分别为0.959(95％可信区间(CI):0.944-0.972),合并特异性为0.957(95％ CI:0.934～0.973),阳性似然比为17.853 (95％ CI:11.735～27.161),阴性似然比为0.045(95％ CI:0.025～0.078).结论:本次Meta分析的结果提示LDCT的检查方案可以作为可疑泌尿系结石检查的首选方案,但研究有异质性和偏倚,需要进行进一步研究.
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