心脏磁共振对定量评估二尖瓣反流诊断价值的meta分析：与二维经胸超声心动图比较

Measurement of mitral regurgitant volume with cardiac magnetic resonance vs two-dimensional transthoracic echocardiography： a meta-analysis

关键词:  心脏磁共振  二维经胸超声心动图  二尖瓣反流  反流容积  meta分析

Key words:  cardiac magnetic resonance  two-dimensional transthoracic echocardiography  mitralregurgitation  regurgitant volume  meta-analysis

摘要:

目的以二维超声心动图为对照检查方法,利用meta汇总分析评价心脏磁共振对定量评估二尖瓣反流的诊断价值。方法制定纳入和排除标准,筛选从Pubmed、EMbase、Cochrane Library、CNKI、CBM和VIP数据库中检索得到的文献,提取纳入研究的特征信息。数据分析采用R软件,根据异质性检验结果选择相应的效应模型。对纳入研究进行加权定量合并,计算汇总的加权均数差和95%的可信区间,并绘制漏斗图来明确有无发表性偏倚。结果共纳入6篇英文文献,8个研究,共计262例患者。纳入研究间存在异质性,选择随机效应模型进行汇总分析,汇总加权均数差为-1.68（95%CI：-6.84~3.49）,包含0值。纳入研究间发表性偏倚不明显。结论在测量二尖瓣反流容积方面,心脏磁共振和二维经胸超声心动图有相似的精确性。

Abstract:

Objective To evaluate the accuracy of mitral regurgitant volume by cardiac magnetic resonance （CMR） in comparison with two-dimensional transthomcic echocardiography （TIE） by meta- analysis. Methods Electronic databases （Pubmed, EMbase, Cochrane Library, CNKI, CBM, VIP） and reference lists for relevant published studies were searched. The characteristics of the included articles were appraised and extracted. Statistical analysis was performed by R software. Heterogeneity of the included articles was tested to select proper effect model. Meta-analysis of weighted mean difference （WMD） were used to quantify the mean difference between CMR and TIE. The publication bias was tested by funnel plot. Results Six English papers of 8 studies with a total of 262 patients were included. The results of meta-analysis showed that there was no significant difference in measurement of mitral regurgitant volume betweenCMRandTIEwithaWMDof-l.68（95%CI：-6.84-3.49）. Conclusion CMR can provide equal accuracy of mitral regurgitant volume measurement as TIE.