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目的对MRI、MDCT检测下腔静脉癌栓及癌栓侵犯血管壁的价值进行系统评价。方法计算机检索PubMed、EMbase、Cochrane图书馆、MELINE(Ovid)、CBM、CNKI、VIP及WanFang Data的相关英文及中文文献,检索时限为2000年1月～2012年2月。按照纳入和排除标准选择文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5、Meta-disc 1.4软件对纳入文献进行异质性检验及Meta分析。结果共纳入6篇文献,244例患者,246例肾癌。Meta分析结果显示:MRI和MDCT组的敏感度分别为0.963、0.952,特异度分别为0.969、0.979,+LR分别为9.759、15.57,–LR分别为0.091、0.108,dOR分别为198.71、251.54。各组合并效应量间均无统计学差异(P>0.05)。MDCT组的SROC曲线下面积(AUC)为0.981 8,Q*0.940 7。结论 MRI与MDCT诊断肾癌下腔静脉癌栓的差异无统计学意义。由于现有资料有限,今后还应更多地进行关于癌栓侵犯血管壁的原始研究。
Objective To systematically evaluate the value of MRI and MDCT in detecting inferior vena cava tumor thrombus and tumor emboli invaded by vascular wall. Methods The relevant English and Chinese documents of PubMed, EMbase, Cochrane Library, MELINE (Ovid), CBM, CNKI, VIP and WanFang Data were searched by computer. The search time was from January 2000 to February 2012. After selecting the literature according to the inclusion and exclusion criteria, extracting the data and evaluating the quality of the methodology included in the study, RevMan 5 and Meta-disc 1.4 software were used to perform heterogeneity tests and meta-analyzes of the included articles. Results A total of 6 articles were included, 244 patients and 246 renal cancer. The results of Meta analysis showed that the sensitivities of MRI and MDCT were 0.963,0.952, 0.969,0.979 respectively, + LR were 9.759 and 15.57 respectively, and the values of -LR were 0.091,0.108 and dOR were 198.71 and 251.54 respectively. There was no significant difference between the combined effect and the effect (P> 0.05). The area under the curve of SROC in the MDCT group (AUC) was 0.981 8 and Q * 0.940 7. Conclusion There is no significant difference between MRI and MDCT in the diagnosis of IVC tumor thrombus. Due to the limited information available, more initial studies on the involvement of thrombus in the vessel wall should be conducted in the future.