Song Gwan Gyu, Bae Sang-Cheol, Lee Young Ho
Division of Rheumatology, Department of Internal Medicine, Korea University College, Seoul, Korea.
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
Clin Exp Rheumatol. 2016 Jan-Feb;34(1):11-6. Epub 2016 Jan 20.
The purpose of this study was to evaluate and compare the diagnostic performance of lung ultrasound (US) in respect to high-resolution computed tomography (HRCT) findings in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD).
We searched the Pubmed, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of lung US according to B-lines (comet tail sign) and on the correlation coefficients between lung US scores and HRCT Warrick scores in CTD-ILD patients.
Five studies that included a total of 349 patients were available for this meta-analysis. The pooled sensitivity and specificity of lung US were 91.5% (95% confidence interval [CI]: 84.5-96.0) and 81.3% (95% CI: 74.6-86.9), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 4.100 (2.133-7.879), 0.176 (0.006-0.363), and 34.73 (10.10-99.66), respectively. The area under the curve was 0.915 and the Q* index was 0.848, indicating a high diagnostic accuracy. When all four studies with systemic sclerosis were considered together, the pooled sensitivity and specificity of lung US were 89.5% (95% CI 80.3-95.3) and 79.6% (69.9-87.2), respectively. A significant correlation was found between lung US B-line scores and HRCT Warrick scores in CTD-ILD (correlation coefficient: 0.783; p-value <1 × 10-9).
Our meta-analysis of published studies demonstrates that lung US has a high diagnostic accuracy, correlates well with HRCT findings, and plays an important role in the diagnosis of CTD-ILD.
本研究旨在评估并比较肺超声（US）相对于高分辨率计算机断层扫描（HRCT）在结缔组织病相关间质性肺病（CTD-ILD）患者中的诊断性能。
我们检索了PubMed、Embase和Cochrane图书馆数据库，并根据B线（彗尾征）对肺超声的诊断准确性以及CTD-ILD患者肺超声评分与HRCT沃里克评分之间的相关系数进行了荟萃分析。
五项研究共纳入349例患者，可用于本次荟萃分析。肺超声的合并敏感性和特异性分别为91.5%（95%置信区间[CI]：84.5-96.0）和81.3%（95%CI：74.6-86.9）。阳性似然比、阴性似然比和诊断比值比分别为4.100（2.133-7.879）、0.176（0.006-0.363）和34.73（10.10-99.66）。曲线下面积为0.915，Q*指数为0.848，表明诊断准确性高。当将所有四项系统性硬化症研究综合考虑时，肺超声的合并敏感性和特异性分别为89.5%（95%CI 80.3-95.3）和79.6%（69.9-87.2）。在CTD-ILD中，肺超声B线评分与HRCT沃里克评分之间存在显著相关性（相关系数：0.783；p值<1×10-9）。
我们对已发表研究的荟萃分析表明，肺超声具有较高的诊断准确性，与HRCT结果相关性良好，在CTD-ILD的诊断中发挥着重要作用。
