【摘要】 目的对已发表的脂肪肝影像学诊断试验研究进行系统评价,为脂肪肝的临床诊断和筛检提供决策依据。方法检索中国生物医学文献光盘数据库、PubMed和EMBASE,手工检索中文文献,检索日期至2002年11月。纳入所有评价人类脂肪肝影像学诊断试验的研究。2名评价员独立提取资料,按照既定的质量评价标准评价研究的质量。根据可供分析的资料,进行综合定量评价或定性评价。结果符合纳入标准的研究共13篇,其中评价B超诊断的研究有10篇,评价增强(螺旋)CT的3篇。用调整SROC法综合评价7篇以肝活检为对照的B超诊断性试验:灵敏度为0.89(95%可信区间0.87～0.92),特异度为0.94(95%可信区间0.92～0.96),Q值为0.90;综合评价2篇以常规CT为对照的B超诊断性试验,结果显示其灵敏度、特异度和Q值分别为0.92(95%可信区间0.89～0.96)、0.88(95%可信区间0.84～0.92)和0.90。结论B超可作为临床上诊断和筛检脂肪肝的有效方法;诊断性试验研究的方法学质量亟待提高。更多还原

【Abstract】 Objective To systematically assess imaging diagnostic tests for fatty liver and provide a decision-mak-ing basis for clinical diagnosis and screening. Methods Electronic searches were conducted on the Chinese Biomedical Database? PubMed? and EMBASE? combining with manually searching of Chinese literature. All searches were completed until November 2002. All studies which evaluated imaging diagnostic test of human fatty liver were included. Data of diagnostic accuracy in the included studies were extr-acted? and methodological quality of the studies was assessed independently by two reviewers according to the established quality standard. Quantitative analysis or qualitative description were performed based on available data. Results Of 13 studies that met the eligibility criteria? 10 studies evaluated the diagnostic accuracy of B-mode ultrasound? 3 studies evaluated contrast-enhanced?(helical?)CT. To assess 7 diagnostic test studies for fatty liver that used liver biopsy as reference test?押 the pooled sensitivity of B-mode ultrasound was 0.89?(95% confidence interval 0.87 - 0.92?)? specificity was 0.94?(95% confidence interval 0.92-0.96?)and the Q value was 0.90 by adjusted SROC method. To assess 2 diagnostic test studies for fatty liver that used CT as reference test?押 the pooled sensitivity? specificity? and Q value were 0.92?(95% confidence interval 0.89-0.96?)? 0.88?(95% confidence interval 0.84 - 0.92?)? and 0.90 respectively by adjusted SROC method. Conclusions B-mode ultrasound method can be regarded as an effective method for fatty liver diagnosis and screening. The methodologic quality of diagnostic test needs to be improved.更多还原