标题：体素内不相干运动扩散加权成像鉴别乳腺良恶性病变的Meta分析

      作者：艾和平，王琦，誾战能，赵丹丹，李红    三峡大学附属仁和医院，湖北 宜昌 443001

      卷次： 2021年32卷3期

      【摘要】 目的 系统评价体素内不相干运动扩散加权成像 (DW-IVIM)鉴别诊断乳腺良恶性病变的价值。方法 检索PubMed、EMbase、维普、CNKI和万方数据库于2010年1月至2020年5月发表的有关DW-IVIM诊断乳腺病变良恶性的相关文献，根据纳入、排除标准进行筛选及质量评价。采用Meta-disc 1.4及Stata 15.1软件对提取出的数据进行统计分析。结果 最终纳入 12篇文献，共 925个病灶，其中良性病灶 364个，恶性病灶 561个。真性扩散系数(D)、假性扩散系数(D*)及灌注分数(f)诊断乳腺良恶性病变的合并敏感度分别为0.82 (95%CI：0.77~0.85)、0.87 (95%CI：0.84~0.89)、0.80 (95%CI：0.76~0.83)，合并特异度分别为0.83 (95% CI：0.77~0.88)、0.83 (95%CI：0.79~0.87)、0.71 (95%CI：0.66~0.76)，诊断比值比分别为 19.89 (95%CI：8.63~45.88)、29.65 (95%CI：20.38~43.15)、13.55 (95%CI：7.22~25.43)，汇总综合受试者工作特征曲线下面积(AUC)分别为0.8743、0.9192、0.8598。结论 ADC值、D值及 f值鉴别诊断乳腺良恶性病变均具有较高的诊断效能，其中D值诊断效能最佳。
      【关键词】 乳腺肿瘤；磁共振成像；扩散加权成像；双指数模型；体素内不相干运动；诊断；Meta分析
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2021）03—0382—05

Intravoxel incoherent motion-based diffusion weighted imaging in the differential diagnosis of benign andmalignant breast lesions: a meta-analysis.
AI He-ping, WANG Qi, YIN Zhan-neng, ZHAO Dan-dan, LI Hong.Affiliated Renhe Hospital of China Three Gorges University, Yichang 443001, Hubei, CHINA
【Abstract】 Objective To systematically evaluate the value of differential diagnosis of benign and malignantbreast lesions by intravoxel incoherent motion-based diffusion weighted imaging (DW-IVIM). Methods Studies relat-ed to diagnosis of benign and malignant breast lesions by DW-IVIM were searched from PubMed, EMbase, VIP, CNKI,and Wanfang databases between January 2010 and May 2020. The articles were screened and evaluated based on inclu-sion and exclusion criteria. Meta-disc 1.4 and Stata 15.1 software were used for statistical analysis. Results A total of12 articles (involving 925 lesions) were enrolled, including 364 benign lesions and 561 malignant lesions. The combinedsensitivity of true diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) values for the di-agnosis of benign and malignant breast lesions was 0.82 (95%CI 0.77—0.85), 0.87 (95%CI 0.84—0.89), 0.80 (95%CI0.76—0.83); the combined specificity was 0.83 (95%CI 0.77—0.88), 0.83 (95%CI 0.79—0.87), 0.71 (95%CI 0.66—0.76);the diagnostic odds ratios was 19.89 (95%CI 8.63—45.88), 29.65 (95%CI 20.38-43.15), 13.55 (95%CI 7.22—25.43); thearea under the curve (AUC) was 0.874 3, 0.919 2, 0.859 8. Conclusion The ADC value, D value, and f value have ahigh diagnostic efficiency in the differential diagnosis of benign and malignant breast lesions, and the D value has thebest diagnostic efficiency.
      【Key words】 Breast tumor; Magnetic resonance imaging; Diffusion weighted imaging; Biexponential model; In-travoxel incoherent motion; Diagnosis; Meta-analysis·荟萃分析·doi:10.3969/j.issn.1003-6350.2021.03.029