MRI和骨掃描對乳腺癌骨轉移診斷價值的Meta分析_《中國循證醫學雜志》

作者：

李蕓芝 ^1,2 , 馬彬 ¹ , 楊克虎 ^1,2 ,  周懷琪 ^1,2,3

1. 蘭州大學循證醫學中心，蘭州大學基礎醫學院（蘭州 730000）；2. 蘭州大學第一臨床醫學院（蘭州 730000）；3. 蘭州大學第一醫院（蘭州 730000）;

關鍵詞：

乳腺癌骨轉移磁共振成像骨掃描 Meta分析

DOI：

10.7507/1672-2531.20100563

視頻：

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目的　評價MRI和骨掃描對乳腺癌骨轉移的診斷價值。
方法　檢索PubMed、EMbase、Cochrane圖書館、CBM、CNKI和VIP等數據庫，按照診斷試驗的納入標準篩選關于MRI和骨掃描對乳腺癌骨轉移診斷價值的診斷試驗，采用QUADAS條目評價納入研究的方法學質量，并采用Meta-Disc 1.4軟件進行Meta分析，繪制匯總受試者工作特征曲線（SROC曲線），計算曲線下面積。
結果　共納入5個研究包括329例研究對象，MRI與骨掃描的敏感度分別為0.99［95%CI（0.97，1.00）］、0.93［95%CI（0.88，0.97）］；特異度分別為0.99［95%CI（0.95，1.00）］，0.86［95%CI（0.79，0.92）］；SROC曲線下面積分別為0.993 6、0.967 5。
結論　MRI可以作為診斷乳腺癌骨轉移有效、可行的方法。

引用本文： 李蕓芝,馬彬,楊克虎,周懷琪. MRI和骨掃描對乳腺癌骨轉移診斷價值的Meta分析. 中國循證醫學雜志, 2010, 10(10): 1159-1163. doi: 10.7507/1672-2531.20100563 復制

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3.	Boxer DI, Todd CE, Coleman R, et al. Bone secodaries in breast cancer: the solitary metastasis. NuclMed, 1989, 30(8): 1318-1320.
4.	Jacoboson AF, Stomper PC, Jochelson MS, et al. Association between number and sites of new bone scan abnormalities and presence of skeletal metastases in patients with breast cancer. J Nucl Med, 1990, 31(4): 387-392.
5.	Nakanishi K, Kobayashi M, Takahashi S, et al. Whole body MRI for detecting metastatic bone tumor: comparison with bone scintigrams. Magn Reson Med Sci, 2005, 4(1): 11-17.
6.	Daldrup-Link HE, Franzius C, Link TM, et al. Whole-body MR imaging for detection of bone metastasis in children andyoung adults: comparison with skeletal scintigraphy and FDG PET. Am J Roentgenol, 2001, 177(1): 229-236.
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8.	Sackett DL, St raus SE, Richardson WS, et al. Evidence-based medicine: How to practice and teach EBM[M] 2nded. London: Churchill Livingstone, 2000. 235-2237, 241-244.
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11.	張天嵩, 鐘文昭. Meta -DiSc軟件在診斷試驗Meta分析中的應用. 循證醫學, 2008, 8(2): 97-100,108.
12.	Zamora J, Abraira V, Muriel A, et al. Meta-DiSc:a software for meta-analysis of test accuracy data. BMC Medical Research Methodology, 2006, 12: 6-31.
13.	Kim DS, Hong SH, Choi JY, et al. Magnetic resonance imaging diagnoses of bone scan abnormalities in breast cancer patients. NuclMedCommun, 2009, 30(9): 736-741.
14.	Yilmaz MH, Ozguroglu M, Mert D, et al. Diagnostic value of magnetic resonance imaging and scintigraphy in patients with metastatic breast cancer of the axial skeleton: a comparative study. Med Oncol, 2008, 25(3): 257-263.
15.	Engelhard K, Hollenbach HP, Wohlfart K, et al. Comparison of whole-body MRI with automatic moving table technique and bonescintigraphy for screening for bone metastases in patients with breast cancer. Eur Radiol, 2004, 14(1): 99-105.
16.	Altehoefer C, Ghanem N, Högerle S, et al. Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer. Eur J Radiol, 2001, 40(1): 16-23.
17.	Layer G, Steudel A, Schüller H, et al. Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma. Cancer, 1999, 85(4): 1004-1009.
18.	Jones AL, Williams MP, Powles TJ, et al. Magnetic resonance imaging in the detection of skeletal metastases in patients with breast cancer. Br J Cancer, 1990, 62(2): 296-298.
19.	Ahmed A, Glynne-Jones R, Ell PJ. Skeletal scintigraphy in carcinoma of the breast-a ten year retrospective study of 389 patients. Nucl Med Commun, 1990, 11(6): 421-426.

1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2): 74-108.
2. Chen HH, Su WC, Guo HR, et al. Clinical significance and outcome of one or two rib lesions on bone scans in breast cancer patients without known metastases. Nucl Med Commun, 2003, 24(11): 1167-1174.
3. Boxer DI, Todd CE, Coleman R, et al. Bone secodaries in breast cancer: the solitary metastasis. NuclMed, 1989, 30(8): 1318-1320.
4. Jacoboson AF, Stomper PC, Jochelson MS, et al. Association between number and sites of new bone scan abnormalities and presence of skeletal metastases in patients with breast cancer. J Nucl Med, 1990, 31(4): 387-392.
5. Nakanishi K, Kobayashi M, Takahashi S, et al. Whole body MRI for detecting metastatic bone tumor: comparison with bone scintigrams. Magn Reson Med Sci, 2005, 4(1): 11-17.
6. Daldrup-Link HE, Franzius C, Link TM, et al. Whole-body MR imaging for detection of bone metastasis in children andyoung adults: comparison with skeletal scintigraphy and FDG PET. Am J Roentgenol, 2001, 177(1): 229-236.
7. Mentzel HJ, Kentouche K, Sauner D, et al. Comparison of whole-body STIR-MRI and 99mTc-methylenediphosphonate scintigraphy in children with suspected multifocal bone lesions. Eur Radiol, 2004, 14(12): 2297-2302.
8. Sackett DL, St raus SE, Richardson WS, et al. Evidence-based medicine: How to practice and teach EBM[M] 2nded. London: Churchill Livingstone, 2000. 235-2237, 241-244.
9. Liehtinghagen R, Bahr M. Noninvasive diagnosis of fibrosis in chronic liver disease. Expert Re Mol Diagn, 2004, 4(5): 715-726.
10. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25-38.
11. 張天嵩, 鐘文昭. Meta -DiSc軟件在診斷試驗Meta分析中的應用. 循證醫學, 2008, 8(2): 97-100,108.
12. Zamora J, Abraira V, Muriel A, et al. Meta-DiSc:a software for meta-analysis of test accuracy data. BMC Medical Research Methodology, 2006, 12: 6-31.
13. Kim DS, Hong SH, Choi JY, et al. Magnetic resonance imaging diagnoses of bone scan abnormalities in breast cancer patients. NuclMedCommun, 2009, 30(9): 736-741.
14. Yilmaz MH, Ozguroglu M, Mert D, et al. Diagnostic value of magnetic resonance imaging and scintigraphy in patients with metastatic breast cancer of the axial skeleton: a comparative study. Med Oncol, 2008, 25(3): 257-263.
15. Engelhard K, Hollenbach HP, Wohlfart K, et al. Comparison of whole-body MRI with automatic moving table technique and bonescintigraphy for screening for bone metastases in patients with breast cancer. Eur Radiol, 2004, 14(1): 99-105.
16. Altehoefer C, Ghanem N, Högerle S, et al. Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer. Eur J Radiol, 2001, 40(1): 16-23.
17. Layer G, Steudel A, Schüller H, et al. Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma. Cancer, 1999, 85(4): 1004-1009.
18. Jones AL, Williams MP, Powles TJ, et al. Magnetic resonance imaging in the detection of skeletal metastases in patients with breast cancer. Br J Cancer, 1990, 62(2): 296-298.
19. Ahmed A, Glynne-Jones R, Ell PJ. Skeletal scintigraphy in carcinoma of the breast-a ten year retrospective study of 389 patients. Nucl Med Commun, 1990, 11(6): 421-426.

《中國循證醫學雜志》

MRI和骨掃描對乳腺癌骨轉移診斷價值的Meta分析

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《中國循證醫學雜志》

MRI和骨掃描對乳腺癌骨轉移診斷價值的Meta分析

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