对比MRI与超声对唇腭裂的产前诊断价值:Meta分析-东南大学学报医学版

对比MRI与超声对唇腭裂的产前诊断价值:Meta分析

单位：1. 川北医学院第二临床医学院/南充市中心医院影像科, 四川南充 637000;
2. 川北医学院第二临床医学院/南充市产前诊断中心, 四川南充 637000;
3. 川北医学院第二临床医学院/南充市中心医院妇产科, 四川南充 637000

关键词：胎儿唇腭裂产前诊断磁共振成像超声 Meta分析

分类号：R782.204

出版年·卷·期（页码）：2024·43·第一期（19-24）

摘要：

目的: 采用Meta分析比较磁共振成像(MRI)与超声(US)对唇腭裂产前诊断的临床应用价值。方法: 检索Embase、PubMed、Web of Science、Cochrane Library、万方、维普、中国知网及中国生物医学文献等数据库,查找比较MRI及US对胎儿唇腭裂产前诊断的相关研究,检索时限为2000年1月至2022年12月。计算汇总诊断比值比、灵敏度、特异度、阳性似然比、阴性似然比、受试者工作特性曲线下面积(AUC)、验前验后概率及95%CI。结果: 纳入文献6篇,共235例。MRI和US合并灵敏度分别为0.98(95%CI: 0.94~0.99)和0.70(95%CI: 0.35~0.91),差异有统计学意义(P<0.05)。MRI和US合并特异度分别为0.84(95%CI: 0.76~0.90)和0.59(95%CI: 0.21~0.89),差异有统计学意义(P<0.05)。MRI的AUC显著高于US的AUC(0.98vs.0.84,P<0.05)。结论: 对于胎儿唇腭裂的产前诊断,MRI较US诊断效能更高,可作为产前US诊断的首要补充方法。

Objective: To use Meta-analysis to compare magnetic resonance imaging(MRI) with ultrasound(ultrasound,US) for prenatal diagnosis of fetal cleft lip and palate. Methods: Embase,PubMed,Web of Science,Cochrane Library,Wanfang,Weipu,CNKI and Chinese Biomedical Literature were searched to find all relevant studies comparing MRI and US for prenatal diagnosis of cleft lip and palate in fetuses,and the search period was from January 2000 to December 2022,meanwhile,the references of the included articles were reviewed. Inclusion and exclusion criteria were developed,and Stata 17.0 was used for Meta-analysis. Pooled diagnostic odds ratio(DOR),sensitivity(SEN),specificity(SPE),positive likelihood ratio(+LR),negative likelihood ratio(-LR),area under the receiver operating characteristic curve(AUC),a priori posterior probability and 95%CI were calculated. Calculation of the Z statistic. Results: Six articles with 235 cases were included. MRI combined sensitivity vs. US combined sensitivity was[0.98(95%CI:0.94-0.99) vs. 0.70(95%CI:0.35-0.91),P<0.05]. MRI combined specificity vs. US combined specificity was[0.84(95%CI:0.76-0.90) vs. 0.59(95%CI:0.21-0.89),P<0.05]. The AUC of MRI was significantly higher than that of US(0.98 vs. 0.84,P<0.05).Conclusion: For prenatal diagnosis of cleft lip and palate in fetuses,MRI has higher diagnostic efficacy than US. Us is the method of choice for fetal cleft lip and palate screening,and MRI examination can be used as the first complementary method for the diagnosis when the diagnosis of cleft palate is unfavorable or cannot be made definitively.

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