Fu Min, Han Fang, Feng Changchao, Chen Tao, Feng Xiaobo
Department of Radiology, The First Hospital of Qinhuangdao, Hebei.
Department of Radiology, Affiliated Zhongshan Hospital of DaLian University, Dalian, Liaoning.
Medicine (Baltimore). 2019 May;98(19):e15580. doi: 10.1097/MD.0000000000015580.
We first introduced this meta-analysis was to assess the accuracy of arterial spin labeling (ASL) in the differentiating high-grade gliomas (HGG) from brain solitary metastases (BSM).
The PubMed, Web of Knowledge, and Cochrane Libraries and China National Knowledge Infrastructure databases were searched up to August 31, 2018. The pooled weighted sensitivity and specificity, summary receiver operating characteristic curve (SROC), sensitivity analysis, and threshold effect analysis were performed on Stata version 12.0 and Meta-Disc version 1.4. Deeks' funnel plot asymmetry test was performed to assess publication bias.
Of 5 eligible articles, of the 346 lesions from 346 patients, 274 were HGG, and 72 were BSM. The forest pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.65, 0.96) and specificity of 0.85 (95% CI: 0.74, 0.92) of ASL were reported in this meta-analysis. The pooled area under the curve of SROC was 0.92 (95% CI: 0.89, 0.94). Sensitivity analysis demonstrated that the pooled estimates were reliable. No evident publication bias was obtained (P = .38).
The parameters derived from ASL with high accuracy in differentiating HGG from BSM. However, results must be interpreted with caution due to the small sample size considered. Large sample prospective studies were necessary to assess and confirm its clinical value.
我们首次开展这项荟萃分析旨在评估动脉自旋标记（ASL）在鉴别高级别胶质瘤（HGG）与脑单发转移瘤（BSM）方面的准确性。
检索截至2018年8月31日的PubMed、Web of Knowledge、Cochrane图书馆及中国知网数据库。在Stata 12.0版和Meta-Disc 1.4版软件上进行合并加权敏感度和特异度、汇总受试者工作特征曲线（SROC）、敏感度分析及阈值效应分析。采用Deeks漏斗图不对称性检验评估发表偏倚。
5篇符合条件的文章中，346例患者的346个病灶，其中274个为HGG，72个为BSM。本荟萃分析报道ASL的森林合并敏感度为0.88（95%置信区间[CI]：0.65，0.96），特异度为0.85（95%CI：0.74，0.92）。SROC曲线下合并面积为0.92（95%CI：0.89，0.94）。敏感度分析表明合并估计值可靠。未发现明显的发表偏倚（P = 0.38）。
ASL得出的参数在鉴别HGG与BSM方面具有较高准确性。然而，鉴于纳入样本量较小，结果解读时须谨慎。需要开展大样本前瞻性研究来评估和确认其临床价值。
