多层螺旋CT和超声心动图对中国人先天性心脏病诊断价值比较的Meta分析

    Multislice Computed Tomography and Echocardiography in the Diagnosis of Congenital Heart Disease in Chinese Population: A Meta-Analysis

    • 摘要: 目的 通过Meta分析对目前诊断中国人先天性心脏病的主要影像学诊断方法(多层螺旋CT和超声心动图)进行对比研究。 方法 采用文献查询、筛选及参考文献复习,对纳入文献进行质量评估,提取纳入研究的特征信息。分别对多层螺旋CT和超声心动图的研究数据分别加权定量合并,计算灵敏度、特异度及其95%可信区间。绘制两种检查的汇总受试者工作特征曲线,计算并比较曲线下面积。 结果 共9篇文献符合纳入标准。研究对象共计1 303处先天性心脏病畸形。与超声心动图相比,多层螺旋CT的总灵敏度、总特异度和诊断心外畸形的灵敏度、特异度较高(Ρ<0.01),受试者工作特征曲线下面积较大。诊断心内畸形时,超声心动图的灵敏度较高(Ρ<0.01),受试者工作特征曲线下面积较大。 结论 对中国人先天性心脏病,尤其是合并有心外畸形时,多层螺旋CT的诊断价值高于超声心动图。超声心动图对心内畸形有较高的诊断价值。

       

      Abstract: Objective To perform a meta-analysis to evaluate multislice computed tomography (MSCT) and echocardiography (ECG) in the diagnosis of congenital heart disease in Chinese population. Methods Literature search and review were done. The characteristics of the included articles were appraised and extracted. The pooled weighted sensitivity and specificity for MSCT and ECG were calculated respectively. SROC curves of the two imaging methods were performed and two areas under the curves (AUC) were calculated and compared. Result 9 of 181 retrieved articles fulfilled the inclusion criteria, with a total of 1 303 cardiac deformities. Totally and in detecting extracardiac anomalies, the pooled weighted sensitivities and specificities for MSCT were higher than that for ECG (Ρ<0.01). The AUC of SROC for MSCT was larger. In intracardiac deformities, the pooled weighted sensitivities for ECG were higher than that for MSCT (Ρ<0.01). The AUC of SROC for ECG was larger. Conclusions MSCT is superior to ECG in the diagnosis of congenital heart disease in Chinese population, especially in detecting extracardiac anomalies, while ECG has a high diagnostic value in intracardiac deformities.

       

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