| 多参数MRI定量及定性分析预测乳腺癌新辅助化疗疗效的Meta分析 |
| 投稿时间：2024-08-17 修订日期：2024-09-18 点此下载全文 |
| 引用本文：杨亭,刘雪雯,姚娟.多参数MRI定量及定性分析预测乳腺癌新辅助化疗疗效的Meta分析[J].医学研究杂志,2025,54(2):103-109 |
| DOI：
10.11969/j.issn.1673-548X.2025.02.017 |
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| 基金项目:国家自然科学基金资助项目(81960339)；新疆医科大学教育研究与教学改革项目(YG2021007) |
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| 中文摘要:目的 评估动态对比增强磁共振成像(dynamic contrast enhanced magnetic resonance imaging, DCE-MRI)以及弥散加权成像(diffusion weighted imaging, DWI)的形态学特征以及定量、定性参数对乳腺癌新辅助化疗的诊断性能。方法 检索PubMed、Embase、Cochrane Library、Web of Science、中国知网和万方数据知识服务平台数据库。检索时限为2014年1月~2024年7月。采用诊断准确性研究质量评价工具2(QUADAS-2)评价纳入研究的方法学质量。提取数据,整理真阳性、假阳性、真阴性、假阴性四格表数据,计算敏感度、特异性、阳性预测值(positive predictive value, PLR)、阴性预测值(negative predictive value, NLR)。采用Stata 13.0和RevMan 5.3软件进行数据合并、异质性检验、Meta回归分析和亚组分析。结果 按照纳入与排除标准选入17篇文献,共纳入2244例乳腺癌患者,平均年龄49.2岁。DCE-MRI合并的敏感度、特异性、PLR、NLR分别为80%、75%、3.20、0.27。DWI合并的敏感度、特异性、PLR、NLR分别为81%、64%、2.30、0.29。亚组分析显示,磁场强度对异质性存在影响,而年龄、研究设计、不同评估参数对异质性均无显著影响。结论 DCE-MRI与DWI对乳腺癌新辅助化疗的诊断疗效无明显差异,当患者无法进行DCE-MRI时,DWI可成为潜在的非侵入性代替检查。 |
| 中文关键词:多参数磁共振成像 乳腺癌 新辅助化疗 Meta分析 |
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| Meta-analysis of Quantitative and Qualitative Multi-parameter MRI Analysis to Predict the Efficacy of Neoadjuvant Chemotherapy for Breast Cancer. |
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| Abstract:Objective To evaluate the morphological characteristics of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI), and the diagnostic performance of quantitative and qualitative parameters in the diagnosis of neoadjuvant chemotherapy for breast cancer. Methods The database of PubMed, EMBASE, Cochrane Library, Web of Science, CNKI and Wanfang Data Knowledge Service Platform databases were searched. The search period was from January 2014 to July 2024. QUADAS-2 was used to evaluate the methodological quality of included studies. Data were extracted, and the data of true positive, false positive, true negative and false negative were sorted out, and the sensitivity, specificity, positive predictive value (PLR) and negative predictive value (NLR) were calculated. Data merging, heterogeneity test, Meta regression analysis and subgroup analysis were performed using Stata 13.0 and RevMan 5.3. Results A total of 2244 breast cancer patients with an average age of 49.2 years were included in 17 literatures according to the inclusion and exclusion criteria. The sensitivity, specificity, PLR and NLR of DCE-MRI were 80%, 75%, 3.20,0.27, respectively. The sensitivity, specificity, PLR and NLR of DWI were 81%, 64%, 2.30,0.29, respectively. Subgroup analysis showed that magnetic field intensity had an effect on heterogeneity, but age, study design and different evaluation parameters had no significant effect on heterogeneity. Conclusion There is no significant difference between DCE-MRI and DWI in the diagnostic efficacy of neoadjuvant chemotherapy for breast cancer. When patients are unable to undergo DCE-MRI, DWI can be a potential non-invasive alternative examination. |
| keywords:Multi-parameter magnetic resonance imaging Breast cancer Neoadjuvant chemotherapy Meta-analysis |
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