摘要
目的探讨频谱多普勒测量甲状腺结节样病变内部动脉血流阻力指数(RI)对鉴别结节良恶性的价值。方法计算机检索Cochrane Database of Systematic Reviews、EBSCO、SCI、CNKI中关于应用甲状腺结节内部RI鉴别甲状腺结节良恶性的前瞻性对照试验,同时手工检索纳入文献的参考文献,无语言限制。入选文献包括应用RI前瞻性预测结节良恶性,且后经病理证实并提供了诊断准确性四格表的独立前瞻性对照研究文献。由3名研究者对文献质量进行严格评价和资料提取,对符合质量标准的前瞻性对照研究进行Meta分析。结果共纳入文献10篇,甲状腺结节样病变共957个,其中经病理检查证实恶性结节400个。结节内部RI>0.7被认为可能是结节恶性,总体敏感度为0.630,95%可信区间为(0.581～0.677);整体特异性为0.774,95%可信区间(0.738～0.808);阳性似然比为3.37,95%可信区间(2.23～5.09);阴性似然比为0.41,95%可信区间(0.26～0.67);诊断比值比为8.85,95%可信区间(4.42～18.55)。结论单独应用结节内部动脉RI预测甲状腺结节良恶性的敏感性和特异性均较低,尚不能作为独立指标预测结节良恶性。
Objective To evaluate the value of arterial resistance index （RI） of thyroid nodules measured by Doppler in differential diagnosis of benign and malignant lesions. Methods The prospective controlled trials identifying the properties of thyroid nodules with arterial IR were searched in Cochrane Database of Systematic Reviews,EBSCO,SCI and CNKI,and a manual search of the enrolled documents＇ references without language limit was conducted. The enrolled documents included independent prospective controlled trials identifying the properties of thyroid nodules with RI which were confirmed by pathology and provided fourfold table of diagnostiec accuracy. Strict evaluation of the documents＇ quality and data extraction were conducted by three researchers, and a Meta-analysis was performed to evaluate the prospective controlled trials up to quality standards. Results Ten prospective controlled trials were enrolled, including 957 nodules of thyroid nodular disease, in which 400 malignant nodules were confirmed by pathology. The arterial RI 〉 0.7 suggested malignant nodules, the total sensitivity was 0.630 and the 95% interval confidence was （0.581, 0.677 ） ;The total specificity was 0.774 and the 95 % interval confidence was （0.738,0.808） ;The positive likelihood ratio was 3. 3795% and the 95% interval confidence was （2.23,5.09） ;The negative likelihood ratio was 0.41 and the 95% interval confidence was （0.26,0.67） ; The diagnostic odds ratio （DOR） was 8.85 and the 95% interval confidence was （4.42,18.55）. Conclusion The sensitivity and specificity of identifying the properties of thyroid nodules with RI individually are low, RI can not be used as an independent factor for identifying the properties of thyroid nodules.
出处
《广西医学》
CAS
2013年第2期166-169,178,共5页
Guangxi Medical Journal
