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目的采用Meta分析方法,评价体素内不相干运动(IVIM)中D值鉴别乳腺良恶性病变的诊断价值。方法检索Pubmed、Embase、CBM、CNKI、万方数据库建库至2015年11月间收录的应用IVIM D值鉴别乳腺良恶性病变的中英文文献,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献及进行质量评价,提取纳入研究的特征信息,采用Stata 12.0软件对纳入文献进行Meta分析。结果共纳入文献10篇,研究病灶共计710个。D值鉴别乳腺良恶性病变的汇总敏感性、特异性、阳性似然比、阴性似然比和SROC曲线下面积分别为:90%(95%CI0.87~0.93)、85%(95%CI 0.75~0.91)、5.9(95%CI 3.4~10.1)、0.12(95%CI 0.08~0.17)、0.92(95%CI 0.90~0.94)。D值提示恶性的乳腺病变验后恶性率为90%,D值提示良性的乳腺病变验后恶性率为15%。经Deeks线性回归分析,纳入文献无发表偏倚。结论 IVIM D值有助于乳腺良恶性病变的鉴别。
Objective To evaluate the diagnostic value of D value in differential diagnosis of benign and malignant breast lesions by using the Meta analysis. Methods Pubmed, Embase, CBM, CNKI, Chinese and English documents for identifying benign and malignant breast lesions using PubMed, Embase, CBM, CNKI, Wanfang database to November 2015 were included in this study. Standard screening literature was included in the diagnostic tests recommended by the Cochrane Collaboration Quality evaluation was carried out, feature information included in the study was extracted, and Meta analysis of the included documents was conducted using Stata 12.0 software. Results A total of 10 articles were included in the study, a total of 710 study lesions. The combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the SROC curve for differential diagnosis of benign and malignant breast lesions were 90% (95% CI 0.87 to 0.93), 85% (95% CI 0.75 to 0.91), 5.9 (95% CI 3.4 to 10.1), 0.12 (95% CI 0.08 to 0.17), and 0.92 (95% CI 0.90 to 0.94). D values suggest malignant breast lesions post-test the malignant rate was 90%, D value suggests that benign breast lesions post-test the malignant rate was 15%. Deeks linear regression analysis, included in the literature without publication bias. Conclusion The IVIM D value is helpful for the differential diagnosis of benign and malignant breast lesions.