摘要
目的利用Meta分析评价和比较氟脱氧葡萄糖-正电子发射断层显像(fluorodeoxyglucose-positron-e-mission tomography,FDG-PET)、单光子发射计算机断层显像(single-photon emission tomography,SPECT)及结构性磁共振成像(magnetic resonance imaging,MRI)这三种临床常用的神经显像方法对轻度认知障碍(mild cognitive impair-ment,MCI)预后的预测价值。方法在MEDLINE数据库中检索1990年1月至2009年4月发表的英文文献。制定纳入标准对文献进行筛选以保证纳入研究的同质性。对符合标准的所有研究结果进行Meta分析和Meta回归分析。估计和比较三种显像方法的加权灵敏度、特异性、似然比(likelihood ratios,LR)和接受者工作特征(receiver op-erating characteristic,ROC)曲线。利用Meta回归和亚组分析方法探讨纳入研究间异质性的来源。结果 20篇文献符合全部纳入标准,含794例MCI患者。三种方法的比值比(odds ratio,OR)和阳性LR值的比较结果提示,FDG-PET对MCI预后的预测能力显著高于其他两种显像方法;然而,三种预测方法的灵敏度、特异性和阴性LR值并无显著性差异。FDG-PET、SPECT和MRI的Q*值分别是0.89、0.79和0.80。Meta回归分析发现,logOR只与显像方法的选择存在回归关系。结论 FDG-PET对MCI患者预后的预测能力略优于SPECT和MRI,而后两者的预测能力没有显著差异。
Objective To evaluate the values of different brain imaging including FDG-PET, SPECT and MRI in predicting the conversion from mild cognitive impairment （ MCI ） to Alzheimer disease in patients with MCI. Methods Relevant studies were identified through MEDLINE search from January 1990 to April 2009. Meta-analysis and meta-regression were conducted on brain image data from eligible studies. The weighted summary sensitivities, specificities, likelihood ratios （LRs） , and summary receiver operating characteristic curves of each imaging technique were calculated and then compared. Results Twenty eligible studies were included, with a total of 794 patients. FDG-PET performed statistically better than either SPECT or MRI in terms of LR ＋ and odds ratio （OR）. However, there were no significant differences in sensitivity, specificity, and LR among those three brain images. The Q ＊ indexes for FDG-PET, SPECT, and structural MR were 0. 89, 0. 79, and 0. 80, respectively. Meta-regression only revealed that log OR was associated with selection of brain imaging. Conclusions The present recta-analysis suggest that FDG-PET performs slightly better than SPECT and structural MR imaging in the prediction of conversion of MCI to AD in patients with MCI.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2011年第2期92-96,共5页
Chinese Journal of Nervous and Mental Diseases
基金
上海市卫生局科研基金资助项目(编号:2008077)
