Kan Ying, Yuan Leilei, Meeks Jacqui K, Li Chunlin, Liu Wencao, Yang Jigang
Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Acta Radiol. 2015 May;56(5):565-72. doi: 10.1177/0284185114533682. Epub 2014 Jun 10.
Ventilation perfusion single photon emission computed tomography (V/Q SPECT) and CT pulmonary angiography have all been used in the diagnosis of acute PE. Previous studies have shown higher sensitivity and specificity and a marked decrease in the non-diagnostic rate of V/Q SPECT than planar scan.
To systematically review and perform a meta-analysis of published data on the performance of V/Q SPECT in the diagnosis of acute PE.
A comprehensive computer search was conducted on literature published through 31 December 2013 in an effort to find relevant articles on the diagnostic performance of V/Q SPECT in the diagnosis of PE patients. Pooled sensitivity, specificity, negative likelihood ratio (LR), and positive LR, the area under the receiver-operating characteristic (ROC) curve of V/Q SPECT in the diagnosis of PE patients were calculated.
Nine studies, comprising a total sample size of 3454 patients, were included in our meta-analysis. The pooled sensitivity, specificity of V/Q SPECT in the diagnosis of acute PE patients, calculated on a per-patient-based analysis, was 96% (95% confidence interval [CI], 95-97%), 97% (95% CI, 96-98%). The pooled negative LR, positive LR of V/Q SPECT in acute PE patients was 0.06 (range, 0.02-0.19) and 16.64 (range, 9.78-31.54). The area under the ROC curve of V/Q SPECT in the diagnosis of acute PE patients was 0.99 on a per-patient-based analysis.
V/Q SPECT is an accurate method in acute PE patients with high sensitivity and high specificity in the diagnosis of PE.
通气灌注单光子发射计算机断层扫描（V/Q SPECT）和CT肺血管造影均已用于急性肺栓塞（PE）的诊断。既往研究表明，V/Q SPECT较平面扫描具有更高的敏感性和特异性，且非诊断率显著降低。
系统评价并对已发表的关于V/Q SPECT诊断急性PE性能的数据进行荟萃分析。
对截至2013年12月31日发表的文献进行全面的计算机检索，以查找有关V/Q SPECT诊断PE患者的诊断性能的相关文章。计算V/Q SPECT诊断PE患者的合并敏感性、特异性、阴性似然比（LR）和阳性LR，以及受试者操作特征（ROC）曲线下面积。
9项研究纳入我们的荟萃分析，总样本量为3454例患者。基于患者的分析计算得出，V/Q SPECT诊断急性PE患者的合并敏感性为96%（95%置信区间[CI]，95 - 97%），特异性为97%（95% CI，96 - 98%）。V/Q SPECT诊断急性PE患者的合并阴性LR为0.06（范围，0.02 - 0.19），阳性LR为16.64（范围，9.78 - 31.54）。基于患者的分析中，V/Q SPECT诊断急性PE患者的ROC曲线下面积为0.99。
V/Q SPECT是诊断急性PE患者的一种准确方法，对PE的诊断具有高敏感性和高特异性。
