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中华老年骨科与康复电子杂志 ›› 2022, Vol. 08 ›› Issue (04) : 250 -256. doi: 10.3877/cma.j.issn.2096-0263.2022.04.010

Meta分析

比较CT和MRI成像技术评估髋部隐匿性骨折诊断效能的meta分析
张祖卓, 王亚丽, 韩东东, 刘娜, 吴文娟, 刘海甜()   
  1. 050051 石家庄,河北医科大学第三医院放射科
    050051 石家庄,河北医科大学第三医院CT室
    050021 石家庄,河北省军区石家庄第五离职干部休养所门诊部
  • 收稿日期:2022-06-15 出版日期:2022-08-05
  • 通信作者: 刘海甜
  • 基金资助:
    河北省医学科学研究课题计划(20210341)

To compare the diagnostic efficacy of CT and MRI in the evaluation of occult hip fracture: A Meta-Analysis

Zuzhuo Zhang, Yali Wang, Dongdong Han, Na Liu, Wenjuan Wu, Haitian Liu()   

  1. Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
    Department of CT, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
    Department of outpatient, The Fifth Retired Cadre Rest Center of Hebei Military Region, Shijiazhuang 050021, China
  • Received:2022-06-15 Published:2022-08-05
  • Corresponding author: Haitian Liu
引用本文:

张祖卓, 王亚丽, 韩东东, 刘娜, 吴文娟, 刘海甜. 比较CT和MRI成像技术评估髋部隐匿性骨折诊断效能的meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2022, 08(04): 250-256.

Zuzhuo Zhang, Yali Wang, Dongdong Han, Na Liu, Wenjuan Wu, Haitian Liu. To compare the diagnostic efficacy of CT and MRI in the evaluation of occult hip fracture: A Meta-Analysis[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(04): 250-256.

目的

对髋部隐匿性骨折资料进行汇总,综合目前CT和MRI的成像技术,分析更好的诊断方式。

方法

采用Meta分析对英文文献数据库自建库至2022年发表的有关CT和MRI评估髋部隐匿性骨折的文献进行统计学分析,其中采用Review Manager 5.3软件对纳入研究的异质性进行分析,应用软件STATA 12.0对发表偏倚进行检验。

结果

经过仔细阅读摘要后共排除34篇。最终纳入本研究10篇。MRI诊断价值的AUC(Area Under Curve)面积虽然大于CT诊断价值,未见明显统计学差异(Z=1.33<1.96,P>0.05);MRI诊断髋部隐匿性骨折特异度明显高于CT诊断价值(P<0.05)。

结论

对于髋部外伤后X线检查阴性,但仍然怀疑为有骨折或疼痛症状明显的患者,推荐MRI成为必查项,可以显著提高隐匿性骨折的检出率和诊断的正确性,为临床诊断和合理选用治疗方案提供准确可靠依据。

Objective

To summarize the data of occult hip fracture and analyze better diagnostic methods by comparing CT and MRI imaging techniques.

Methods

The literature on CT and MRI evaluation of occult hip fractures published in the English literature database from the establishment of the database to 2022 was statistically analyzed by meta-analysis. The heterogeneity of the included studies was analyzed by Review Manager 5.3 software, and the publication bias was tested by Stata 12.0 software.

Results

10 articles were finally included in this study. Although the AUC area of MRI was greater than that of CT, there was no significant difference (z=1.33<1.96, P>0.05); The specificity of MRI in the diagnosis of occult hip fracture was significantly higher than that of CT(P<0.05).

Conclusions

for patients with negative X-ray examination after hip trauma, but still suspected to have obvious fracture or pain symptoms, MRI is recommended as a necessary item, which can significantly improve the detection rate and diagnostic accuracy of occult fracture, and provide accurate and reliable basis for clinical diagnosis and reasonable selection of treatment scheme.

图1 文件检索与筛选流程图
表1 纳入文献的基本特征
表2 纳入文献的CT四格表数据
表3 纳入文献的MRI四格表数据
图2 纳入文献质量评价结果
图3 CT评估髋部隐匿性骨折的诊断价值异质性分析
图4 MRI评估髋部隐匿性骨折的诊断价值异质性分析
图13 患者从入院到进行检查的CT和MRI时间间隔比较
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