Objective To systemically evaluate the accuracy of f/t-PSA for diagnosing prostate cancer with a t-PSA level of 4-10ng/mL through meta-analysis. Methods A literature search of CBM, VIP, CNKI and Wanfang Data from 1999 to 2009 was performed. Related journals were also searched manually. Two reviewers independently assessed trial quality according to QUADAS items. Heterogenous studies and meta-analysis were conducted by Meta-Disc1.4 software. The analysis was based on different critical values of f/t-PSA (0.1, 0.15, 0.2, 0.25, and 0.3). Results Total 18 studies involving 2217 subjects were included. No threshold effect was found. But there was heterogeneity due to other factors. The meta–analysis showed that, the sensitivity of f/t-PSA with the critical value of 0.15 for the diagnosis of prostate cancer with a t-PSA level of 4-10ng/mL was 75% (95%CI 70%-79%), and the specificity was 81% (95%CI 78%-84%). The area under SROC curve was 0.883 5, and the Q index was 0.814 0. Conclusion The f/t-PSA is a better index for diagnosing prostate cancer with t-PSA levels between 4 and 10ng/mL. And it is reasonable to consider 0.15 as a more suitable critical value.
【摘要】 目的 探讨常规MRI扫描及胰胆管造影（MRCP）对胆管梗阻性疾病的临床诊断价值。 方法 2006年4月-2010年6月，对59例胆管梗阻性疾病患者行常规MRI及MRCP检查，其中18例行动态增强扫描，并与临床诊断或手术、病理结果对照分析。MRCP采用不屏气厚层快速自旋回波（FSE）序列重度T2WI扫描，原始图像以最大信号强度投影（MIP）法进行三维重建。 结果 MRI及MRCP对胆管梗阻程度的判断和定位诊断准确率为100.0%，定性诊断准确率为91.5%，其中MRCP诊断胆管结石和恶性胆管梗阻的准确率分别为96.8%和86.9%。 结论 MRCP对胆管梗阻的定位诊断准确，结合3D原始图像、常规MRI扫描及动态增强扫描，对胆管结石和恶性胆管梗阻的定性诊断有很高的准确性。【Abstract】 Objective To evaluate the clinical diagnosis value of MRI and cholangiopancreatography (MRCP) in diagnosis of biliary obstructive disease. Methods Routine MRI and MRCP were performed on 59 patients between April 2006 and June 2010, in which dynamic enhance scan was performed on 18 patients. The results were compared with clinical diagnosis or surgical findings and pathological examination. Non-breath-hold thick slices heavy T2 weighted TSE sequence was used. The original images were reconstructed by using three-dimensional maximum-intensity-projection (MIP) algorithm. Results The accuracy of MRI and MRCP in the detection of the degree and level of bile duct obstruction was 100.0 % and the accuracy for evaluating the causes of obstruction was 91.5 %. In the diagnosis of bile duct stone and malignant biliary obstruction, the diagnostic rate of MRCP was 96.8 % and 86.9%. Conclusion Routine MRI and MRCP examination can accurately define the level of bile duct obstruction. Combining with the original images and routine images and dynamic enhance scan, the specificity for the diagnosis of bile duct stone and malignant biliary obstruction is high.