双能源CT诊断冠状动脉狭窄及缺血心肌的Meta分析

摘要

目的 评价双能源CT(DECT)诊断冠状动脉狭窄及缺血心肌的价值.方法 计算机检索PubMed、EMbase、万方、中国知网数据库,纳入双能源CT诊断冠状动脉狭窄及缺血心肌的临床研究.由2名独立的评价人员筛选文献,提取效应量指标数据.采用Meta-Disc 1.4和Stata 12.0软件进行系统分析.结果 以冠状动脉为研究对象,纳入样本320例,冠状动脉943支,DECT诊断冠状动脉狭窄的敏感性、特异性及其95%CI分别为0.89(0.85~0.92)、0.88(0.85~0.90),AUC和Q*分别为0.93和0.86;以心肌节段为研究对象,纳入样本203例,心肌节段3246个,DECT诊断缺血心肌的敏感性、特异性及其95%CI分别为0.92(0.90~0.95)、0.96(0.95~0.97),AUC和Q*分别为0.99和0.95.结论 现有证据显示, DECT可为诊断冠状动脉狭窄及缺血心肌提供依据.%Objective To evaluate the value of dual energy CT (DECT) in the diagnosis of coronary stenosis and ischemic myocardium. Methods We searched PubMed, Embase, Wan Fang and CNKI databases for clinical studies of dual energy CT in diagnosis of coronary stenosis and ischemic myocardium. The literatures were screened by 2 independent reviewers and the effect index was extracted. Meta-Disc 1.4 and Stata 12.0 software are used for analysis. Results With respect to coronary artery, 320 samples and 943 coronary arteries were included. The sensitivity and specificity of DECT for the diagnosis of coronary artery stenosis were 0.89 (95%CI: 0.85~0.92) and 0.88 (95%CI: 0.85~0.90), respectively. AUC and Q* were 0.93 and 0.86, respectively. With respect to myocardial segment, 203 samples and 3246 myocardial segments were included. The sensitivity and specificity of DECT in the diagnosis of ischemic myocardium were 0.92 (95%CI: 0.90~0.95) and 0.96 (95%CI: 0.95~0.97) ,respectively. AUC and Q* were 0.99 and 0.95, respectively. Conclusions Available evidence suggests that DECT may provide a basis for the diagnosis of coronary stenosis and ischemic myocardium.