CAJ | 학술논문

目的采用循证医学荟萃分析方法系统性评价肝移植中全肝体积CT和磁共振影像学测量的准确性.方法检索Cochrane图书馆、中英文文摘数据库(Medline、Embase、中国生物医学文摘数据库)和全文数据库(Springer、OVID、Seiencedirect、CNKI、万方、维普等),获得利用CT或磁共振图像测量供肝全肝体积的中英文文献,按照Cochrane协作网推荐的诊断试验纳入标准对检得文献进行筛选,对纳入文献提取信息进行异质性检验,根据异质性检验结果选择恰当的效应量合并模型,对全肝体积CT和磁共振测量研究进行效应量合并,合并效应量为加权平均差,最后进行敏感性分析,发表性偏倚分析.结果 17篇文献符合纳入标准,报道的37项研究进行了荟萃分析,包括351例患者.异质性检验显示各纳入文献不具异质性(I2 =0％,Q=5.85,P=1),根据固定效应模型进行效应量合并,CT和磁共振影像学测量全肝体积与实际肝体积的加权均数差值为21.61 ml(95％可信区间为-6.33～49.57 ml),差异无统计学意义(z=1.51,P=0.13),敏感性分析显示结果稳定,不因为其中任何一篇文献报道结果的删除发生明显改变,漏斗图分析及发表性偏倚检验提示不存在发表性偏倚(t=-1.55,P=0.13).结论 CT和磁共振是准确的肝体积影像学测量方法,可以为手术患者的术前评估,为术后和其他肝病患者的监测提供重要参考信息.
목적 채용순증의학회췌분석방법계통성평개간이식중전간체적CT화자공진영상학측량적준학성.방법 검색Cochrane도서관、중영문문적수거고(Medline、Embase、중국생물의학문적수거고)화전문수거고(Springer、OVID、Seiencedirect、CNKI、만방、유보등),획득이용CT혹자공진도상측량공간전간체적적중영문문헌,안조Cochrane협작망추천적진단시험납입표준대검득문헌진행사선,대납입문헌제취신식진행이질성검험,근거이질성검험결과선택흡당적효응량합병모형,대전간체적CT화자공진측량연구진행효응량합병,합병효응량위가권평균차,최후진행민감성분석,발표성편의분석.결과 17편문헌부합납입표준,보도적37항연구진행료회췌분석,포괄351례환자.이질성검험현시각납입문헌불구이질성(I2 =0％,Q=5.85,P=1),근거고정효응모형진행효응량합병,CT화자공진영상학측량전간체적여실제간체적적가권균수차치위21.61 ml(95％가신구간위-6.33～49.57 ml),차이무통계학의의(z=1.51,P=0.13),민감성분석현시결과은정,불인위기중임하일편문헌보도결과적산제발생명현개변,루두도분석급발표성편의검험제시불존재발표성편의(t=-1.55,P=0.13).결론 CT화자공진시준학적간체적영상학측량방법,가이위수술환자적술전평고,위술후화기타간병환자적감측제공중요삼고신식.
Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.