【摘要】 目的 评价非增强螺旋CT对成人急性阑尾炎的诊断价值。方法 收集现有国内外公开发表的以手术或病检结果为诊断金标准的关于非增强螺旋CT诊断成人急性阑尾炎的英文、中文文献,按照Meta分析的要求和诊断性试验公认的质量标准对所有的纳入研究进行质量评估,并提取各纳入研究的特征信息。采用STATA10.0软件,检验异质性,根据异质性结果选择相应的效应模型,采用MetaDisc1.4软件计算出汇总敏感度和特异度,以诊断性试验Meta分析特有的综合受试者工作特性曲线(SROC)分析方法定性、定量地评价该诊断方法的准确性。结果 符合纳入标准的文献共11篇,汇总的诊断指标和SROC分析均显示,非增强螺旋CT对成人急性阑尾炎的诊断均有较高的准确度,表示诊断试验准确度的指标汇总敏感度为92.00%(95%可信区间0.89～0.94),汇总特异度为94.00%(95%可信区间0.92～0.96),AUC=0.973 8,Q指数=0.926 1。结论 汇总目前关于非增强螺旋CT诊断成人急性阑尾炎的研究显示,非增强螺旋CT是一种准确性较高的检查方法。更多还原

【Abstract】 Objective To evaluate the overall diagnostic value of non-enhanced helical CT in adults with suspected acute appendicitis.Methods All the papers concerning the diagnosis of acute appendicitis using non-enhanced CT in both English and Chinese published had been searched and reviewed,and the studies with the surgery or pathology as the gold standard were adopted as eligible.Statistical analysis was performed by STATA(vision 10.0) and MetaDisc(vision 1.4).Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity,specificity and accuracy.Non-enhanced helical CT test performance was assessed with summary receiver operating characteristic curve analysis,with independently pooled sensitivity and specificity values across studies.Results Totally 11 studies met the inclusion criteria with a total of 1422 patients.The pooled indexes of diagnostic performance and summary receiver operating characteristic curve(SROC) demonstrated a high discriminatory power for detecting acute appendicitis by non-enhanced helical CT.In the pooled estimates,sensitivity and specificity were 92.00%(95% confidence interval 0.89 to 0.94) and 94.00%(95% confidence interval 0.92 to 0.96) respectively,AUC was 0.9738 and Q index was 0.9261.Conclusion Non-enhanced helical CT may be a highly accurate diagnostic tool for detecting acute appendicitis in adults.更多还原