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目的:采用Meta分析的方法系统评价声辐射力脉冲成像(acoustic radiation force impulse imaging,ARFI)对非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的诊断价值.方法:检索PubMed、Medline、Web ofScience、CNKI、WanFang Data、CBM、Google学术搜索,及追溯参考文献收集相关文献.根据纳入与排除标准筛选文献,采用QUADAS工具评估文献质量并提取数据.采用MetaDisc1.4、STATA12.0软件进行异质性分析,计算合并敏感度、特异度、阳性似然比、阴性似然比等指标,并绘制总受试者工作特征曲线(summary receiver operating characteristics,SROC),最后进行敏感性分析及发表偏倚的评估.结果:共8篇研究纳入本评价研究.Meta分析结果显示ARFI对NAFLD的合并敏感度和特异度分别为90%(95%CI:86%-94%)、78%(95%CI:73%-83%),合并阳性似然比及阴性似然比分别为3.57(95%CI:2.19-5.81)、0.13(95%C I:0.09-0.20),合并诊断比值比35.87(95%CI:19.96-64.48).SROC曲线下面积为0.9326,SE=0.0169,总诊断精确度Q*指数为0.8683.结论:ARFI具有较高的诊断效能,可作为诊断N A F L D的一种相对可靠、安全的无创诊断工具.
OBJECTIVE: To systematically evaluate the diagnostic value of acoustic radiation force impulse imaging (ARFI) in the diagnosis of nonalcoholic fatty liver disease (NAFLD) by Meta-analysis.Methods: PubMed, Medline, Web ofScience, CNKI, WanFang Data, CBM, Google Scholar, and retrospective references.According to inclusion and exclusion criteria, the literature was screened and QUADAS was used to evaluate the quality of the literature and extract the data.MetalDisc 1.4 and STATA12.0 software Qualitative analysis, calculate the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and other indicators, and draw the summary receiver operating characteristics (summary receiver operating characteristics, SROC), the final sensitivity analysis and publication bias Results: A total of 8 studies were included in this review, and Meta-analysis showed that the combined sensitivity and specificity of ARFI for NAFLD were 90% (95% CI: 86% -94%), 78% (95% CI : 73% -83%). The positive likelihood ratio and negative likelihood ratio were 3.57 (95% CI: 2.19-5.81), 0.13 (95% CI: 0.09-0.20) CI: 19.96-64.48) . The area under the curve of SROC was 0.9326, SE was 0.0169, the total diagnostic accuracy Q * index was 0.8683. Conclusion: ARFI has high diagnostic efficacy and can be used as a relatively reliable and safe noninvasive diagnostic tool for the diagnosis of NAFLD.