ObjectiveTo systematically review the diagnostic value of FDG-PET, Aβ-PET and tau-PET for Alzheimer ’s disease (AD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect diagnostic tests of FDG-PET, Aβ-PET and tau-PET for AD from January 2000 to February 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by Meta-Disc 1.4 and Stata 14.0 software.ResultsA total of 31 studies involving 3 718 subjects were included. The results of meta-analysis showed that, using normal population as control, the sensitivity/specificity of FDG-PET and Aβ-PET in diagnosing AD were 0.853/0.734 and 0.824/0.771, respectively. Only 2 studies were included for tau-PET and meta-analysis was not performed.ConclusionsFDG-PET and Aβ-PET can provide good diagnostic accuracy for AD, and their diagnostic efficacy is similar. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
ObjectiveTo observe the imaging features of branching vascular network (BVN) in polypoidal choroidal vasculopathy (PCV). MethodsEighty PCV patients (90 eyes) were enrolled in this study. The patients included 58 males and 22 females. The age was ranged from 49 to 85 years, with a mean age of 61.4 years. All the patients were examined for fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The fibrovascular retinal pigment epithelium detachment (PED) was defined as a well-demarcated subretinal heterogeneous plaque with increasing fluorescence on FFA. The late lichenoid hyperfluorescent plaque was defined as a well-demarcated lichenoid hyperfluorescent plaque on late phase ICGA. The double-layer sign on OCT was defined as a wide range of shallow PED from Bruch membrane. ResultsBVN were found on early ICGA in 76 eyes among the 90 eyes (84.4%). Among these 76 eyes, 18 eyes (23.7%) demonstrated the subretinal reddish-orange branches corresponding to BVN. Fifty-six eyes (73.7%) demonstrated all or part of the BVN on early FFA. Three eyes (3.9%) demonstrated branching transmitted fluorescence corresponding to BVN throughout the FFA. Seventy-three eyes (96.1%) were manifested by occult choroidal vascularization on FFA, and 21 eyes (27.6%) of them were fibrovascular PED. Among the 76 eyes with BVN, all BVN appeared earlier than polypoidal lesions on ICGA. Polypoidal lesions located on the terminal of BVN in 62 eyes (81.6%). Sixty-nine eyes (90.8%) on ICGA demonstrated the late lichenoid hyperfluorescent plaque, whose area was equal to or greater than the area of BVN shown on early ICGA. Seventy-two eyes (94.7%) had the double-layer sign. Among these 72 eyes, 15 eyes (20.8%) had lumen-like structure within the double-layer sign. Sixty-five eyes (90.3%) had punctate and linear hyper-reflectance within the double-layer sign. Two eyes (2.8%) demonstrated a hyporeflective short segment and a gap of Bruch membrane on OCT corresponding to the origin of the BVN. Sixty-three eyes (87.5%) had an area of double-layer sign that matched the area of late lichenoid hyperfluorescent plaque on ICGA. ConclusionsBVN in PCV can be noted as reddish-orange branches on fundus examination. Most of the BVN are shown as early branching transmitted fluorescence but collectively an occult choroidal vascularization on FFA, as lichenoid hyperfluorescent plaque on late ICGA, and as double-layer sign on OCT whose area matches late lichenoid hyperfluorescent plaque.
ObjectiveTo observe the pathological changes of central retinal artery occlusion (CRAO) by optical coherence tomography (OCT).MethodsFifty-three eyes of 53 patients who were diagnosed as CRAO in our center between January 2001 to January 2004 underwent the examination by OCT. The intervals between the disease onset and OCT examination were less than 2 weeks. The scan modes of OCT were horizontal or vertical line scan. The locations of scanning were macular, posterior pole of retina, optical papilla and the focus of bleeding or exudation.ResultsThe OCT pathological changes of CRAO in vivo includes increase of retinal thickness and reflex of retina, width of dark layer of photoreceptor (edema), edema or cystoid edema of fovea, retinal bleeding, cotton-wool spot and papilla edema. Four patients who had ciliary retinal artery showed normal retinal structure in the supply region of ciliary retinal artery.ConclusionOCT can display the pathological changes of retinal tissues in CRAO in vivo, especially on the old patients or the patients with systemic disease who were contraindicated by FFA. The unique OCT image of pathological changes of CRAO supply the objective signs for the instant clinical diagnosis.(Chin J Ocul Fundus Dis, 2005,21:74-78)
Objective To compare the macular imaging and measurements of patients with idiopathic epiretinal membranes (ERM) by stratus optical coherence tomography (OCT) and two different types of spectral-domain OCT. Methods Forty-six consecutive patients (46 eyes) diagnosed as idiopathic ERM in the period of August 2008 to October 2008 were enrolled in this study. The patients included 11 males and 35 females, with a mean age of (61.04plusmn;10.13) years. Twenty-one age- and sex- matched normal subjects (21 eyes) were enrolled in this study as control group. All the subjects underwent stratus OCT, cirrus OCT and 3D OCT-1000 examinations. The macular area was divided into three concentric circles which including central region with 1 mm diameter, inner area with ＞1 mm but le;3 mm diameter, and outer ring area with ＞3 mm but le;6 mm diameter. The inner area and outer ring area were divided into superior, nasal, inferior and temporal quadrants by two radioactive rays. The characteristics of OCT images and the quantitative measurements were compared among these three machines. The macular thickness of ERM group and control group was also compared. And the correlation of visual acuity and the macular thickness in idiopathic ERM patients was evaluated. Results The increased macular retinal thickness, disorder structure of inner retina, uneven surface and proliferative inner and outer plexiform layer were observed in ERM group by stratus and spectral-domain OCT. But the minor pathological changes on inner retina structure and internal surface proliferation could be observed more clearly by spectral-domain OCT than those by stratus OCT.The macular thicknesses of all the subjects measured by Cirrus OCT and 3D OCT-1000 were thicker than those measured by Stratus OCT (t=7.445-11.253,P=0.000). The correlations of measurements between three OCTs were good (r＞0.9). The flatted or disappeared fovea of ERM patient group was observed by all three OCTs. The macular thicknesses on different subfields of patients in ERM group were thicker than those in control group, especially in the 1-3 mm inner ring (t=2.477-10.139,P＜0.05). Moderate negative correlations were shown on the macular thickness and visual acuity in ERM group (r=-0.216-0.517). Conclusions Spectral domain OCT yields better visualization of the intraretinal layers than time domain OCT. The images in spectral domain OCT are more clear and fine compared to stratus OCT. Stratus OCT correlates with spectral domain OCT, but they are different, and cannot be replaced by each other.
ObjectivesTo investigate the diagnostic value of different diffusion-weighted MRI (DWI) models between two Gaussian DWI models including mono-exponential and bi-exponential, and the non-Gaussian kurtosis model in poorly differentiated pancreatic ductal adenocarcinoma.MethodsSubjects comprised 52 patients with poorly differentiated pancreatic ductal adenocarcinoma which had been confirmed by surgery. All patients underwent DWI (1.5T, multi-b values: 0, 50, 100, 150, 200, 500, 800, 1000, 1 500, 2 000s/mm2). Mean values of DWI-derived metrics ADCstandard, ADCslow, ADCfast, f, MD, MK and ADCstandard were calculated from regions of interest in all tumours and non-tumorous parenchyma and compared. ANOVA and Mann Whitney U test was used to compare the MRI paremeters. ROC was used to evaluate the diagnostic efficiency.ResultsMean ADCstandard, ADCfast, f and MK values showed significant differences between tumours and non-tumorous parenchyma (P<0.05). AUC for ADCstandard, MD, ADCfast and f were 0.705, 0.665, 0.648, 0.614, respectively. The ROC curve integrated with ADCstandard and MD had better diagnostic efficiency (AUC was about 0.754).ConclusionsADCstandard, ADCfast, f and MK values can differentiate tumours from non-tumorous parenchyma. The combination of Gaussion distribution model and non-Gaussion distribution model has the potential to increase the diagnostic accuracy of DWI in patients with pancreatic ductal adenocarcinoma.
Objective To assess the quality of diagnostic studies on detecting the tuberculosis antibody to diagnose tuberculosis.Methods CBM (1978 to 2006) and VIP (1994 to 2006) were searched; any author-claimed diagnostic studies which used the dot immunogold filtration assay (DIGFA) to detect the tuberculosis antibody and to diagnose tuberculosis were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to assess the quality of included diagnostic studies by two reviewers independently.Results Thirty-eight papers were included and assessed. We found that most of the quality items were not met with QUADAS. Most papers adopted the retrospective diagnostic case-control design. Thirty-one papers did not describe the selection criteria clearly, 18 did not describe whether all the included patients were verified by using a reference standard of diagnosis, 36 did not describe whether the index test results were interpreted without knowledge of the results of the reference standard, 37 did not report the uninterpretable/intermediate test results, and 34 did not report the withdrawals from the study.Conclusion There are few high quality studies on using DIGFA to detect tuberculosis antibody to diagnose tuberculosis.
ObjectiveTo systematically review the value of intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas. MethodsSuch databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP were electronically searched for the diagnostic test about intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas by March 31st, 2013. Meanwhile, search engines such as Google, Baidu were also used for relevant search. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The methodological quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and then meta-analysis was conducted using Meta-DiSc 1.4 software. ResultsA total of 10 studies involving 423 patients were included. The results of meta-analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were 0.78 (95%CI 0.74 to 0.82), 0.90 (95%CI 0.88 to 0.90), 5.12 (95%CI 2.86 to 9.16), 0.29 (95%CI 0.21 to 0.39) and 25.00 95%CI (13.27 to 47.10), respectively; and the AUC was 0.89. In the subgroup analysis, for low grade intracranial gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.87 (95%CI 0.77 to 0.94), 0.88 (95%CI 0.78 to 0.94) and 28.93 (95%CI 7.46 to 112.14), respectively, and the AUC was 0.92. For high grade gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.80 (95%CI 0.72 to 0.87), 0.67 (95%CI 0.53 to 0.79) and 7.20 (95%CI 3.04 to 17.09), respectively, and the AUC was 0.80. ConclusionIntra-operative ultrasound is useful for the diagnosis of tumor residue after resection of intracranial gliomas, especially for low grade gliomas.
ObjectiveTo systematically review the diagnostic value of ultrasound for breast cancer with axillary sentinel lymph nodes, so as to provide evidence for clinical decision-making. MethodsWe searched the databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CBM, CNKI, WanFang Data and VIP for studies about ultrasound in the diagnosis of breast cancer with axillary sentinel lymph nodes till December 31st, 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and methodological quality of the included studies was evaluated. Meta-analysis was then conducted using Meta-Disc 1.4 software. ResultsA total of 12 studies involving 2 188 cases were included. The pooled results of meta-analysis showed that sensitivity and specificity were 0.75 (95%CI 0.72 to 0.77) and 0.91 (95%CI 0.89 to 0.92), respectively; positive likelihood ratio and negative likelihood ratio were 6.54 (95%CI 4.68 to 8.89) and 0.22 (95%CI 0.15 to 0.33), respectively; diagnostic odds ratio was 33.59 (95%CI 17.87 to 63.12); and the AUC was 0.934 3. ConclusionUltrasound is has relatively high value in diagnosis of breast cancer with axillary sentinel lymph nodes. However, due to the influence caused by the limited quality and various potential heterogeneity, more high quality RCTs with large sample size are needed to further verify the above conclusion.
Objective To evaluate diagnostic value of antifilaggrin autoantibodies (AFA) for rheumatoid arthritis (RA). Methods A systematic, comprehensive literature search was conducted in PubMed (1966 to 2010.8), The Cochrane Library (issue 8, 2010), EMbase (1974 to 2010.8), CBM (1978 to 2010.8), CNKI (1994 to 2010.8), VIP (1989 to 2010.8) and Chinese Medical Association of Digital Periodicals (1997 to 2010.8). The diagnosis studies on AFA versus the standards of American College of Rheumatology for RA were included. QUADAS items were used to evaluate the quality of the included studies. Meta-disc software (version 1.4) was used to analyze data. Sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (–LR) and summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Results A total of 18 articles were included, involving 6 971 cases of subjects from 7 countries. Results of meta-analysis showed that, compared with the standards of American College of Rheumatology, pooled SEN, SPE, +LR, –LR, and SROC curve of AFA were 0.52 (0.50, 0.54), 0.93 (0.92, 0.94), 7.11 (5.35, 9.45), 0.53 (0.48, 0.60), 13.82 (9.93, 19.24), and 0.834 7, respectively. Conclusion IBT, ELISA detection of AFA are of high efficiency in the diagnosis of RA. However, the antigen from human breast skin is not conducive to clinical application.
Cryptococcosis, mainly caused by Cryptococcus neoformans/gattii species complexes, is a lethal infection in both immunosuppressive and immunocompetent populations. With the upgrade of detection methods and the increase of clinical knowledge, the incidence rate of cryptococcosis is increasing, and it has become one of the most important fungi threatening human health. In recent years, great progress has been made in this field, including the taxonomy and nomenclature of Cryptococcus spp., laboratory diagnostic methods and antifungal susceptibility tests, as well as the characteristics and treatments of cryptococcosis. This article reviews the above contents, in order to improve the clinical and laboratory understanding of the Cryptococcus spp., and realize the timely diagnosis and early treatment of cryptococcosis.