Deng Han, Qi Xingshun, Guo Xiaozhong
a Postgraduate College , Dalian Medical University , Dalian , China.
b General Hospital of Shenyang Military Command - Department of Gastroenterology , Shenyang , China.
Postgrad Med. 2017 Apr;129(3):318-328. doi: 10.1080/00325481.2017.1241664. Epub 2016 Oct 8.
This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of contrast-enhanced computed tomography (CT) for varices in liver cirrhosis.
PubMed and EMBASE databases were searched for the literature identification. The area under the summary receiver operating characteristic curve (AUSROC), sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), and diagnostic odds ratio (DOR) were calculated. We performed the subgroup analyses according to the location of varices, CT technique, and study design. The study quality was assessed according to the QUADAS-2 tool.
Seventeen papers were eligible. The study quality was modest. The AUSROC was 0.8975 and 0.9494 for predicting any size and high-risk varices, respectively. Summary sensitivity, specificity, PLR, NLR, and DOR of CT for predicting any size and high-risk varices were 0.87/0.80/3.67/0.18/22.70 and 0.87/0.88/7.52/0.12/65.55, respectively. According to the location of varices, the AUSROC was 0.9127 for predicting any size gastric varices alone; and the AUSROC was 0.8958 and 0.9461 for predicting any size and high-risk esophageal varices alone, respectively. According to the CT technique, the AUSROC of multi-detector CT (MDCT) was 0.9047 and 0.9490 for predicting any size and high-risk varices, respectively; and the AUSROC of MDCT esophagograms for predicting any size and high-risk varices was 0.8735 and 0.9664, respectively. In the subgroup analysis of prospective studies, the AUSROC was 0.9122 and 0.9507 for predicting any size and high-risk varices, respectively.
CT had a high accuracy for the diagnosis of varices in liver cirrhosis.
本系统评价和荟萃分析旨在评估对比增强计算机断层扫描（CT）对肝硬化静脉曲张的诊断准确性。
检索PubMed和EMBASE数据库以识别文献。计算汇总受试者工作特征曲线下面积（AUSROC）、敏感性、特异性、阳性和阴性似然比（PLR和NLR）以及诊断比值比（DOR）。我们根据静脉曲张的位置、CT技术和研究设计进行亚组分析。根据QUADAS - 2工具评估研究质量。
17篇论文符合要求。研究质量中等。预测任何大小和高危静脉曲张的AUSROC分别为0.8975和0.9494。CT预测任何大小和高危静脉曲张的汇总敏感性、特异性、PLR、NLR和DOR分别为0.87/0.80/3.67/0.18/22.70和0.87/0.88/7.52/0.12/65.55。根据静脉曲张的位置，单独预测任何大小胃静脉曲张的AUSROC为0.9127；单独预测任何大小和高危食管静脉曲张的AUSROC分别为0.8958和0.9461。根据CT技术，多排螺旋CT（MDCT）预测任何大小和高危静脉曲张的AUSROC分别为0.9047和0.9490；MDCT食管造影预测任何大小和高危静脉曲张的AUSROC分别为0.8735和0.9664。在前瞻性研究的亚组分析中，预测任何大小和高危静脉曲张的AUSROC分别为0.9122和0.9507。
CT对肝硬化静脉曲张的诊断具有较高准确性。
