目的 通过Meta分析研究方法对 弥散加权成像磁共振检查方法评价肝纤 维化分级诊断的准确性做出分析。方法 通过检索国内外公开发表的DWI评价肝纤 维化分级诊断准确性的文章，并且采用 Metavir、Scheuer、Batts-Ludwig计分系 统标准进行分级。两名研究人员按照纳入 与排除标准独立选择文献并根据QUADAS 评价条目标准进行质量评价。使用MetaDisc软件进行Meta分析，并绘制SROC曲 线。结果 检索到247篇相关文献，最终纳 入了10项1.5 T场强研究和3项3.0 T场强 研究，受试者总数为809例。Meta分析结 果示各组间存在统计学异质性，采用随机 效应模型合并分析。DWI磁共振检查方法 对轻度肝纤维化(G1)组、明显肝纤维化 (G2)组、严重肝纤维化(G3)组、早期肝硬 化(G4)组的合并灵敏度和特异度分别为： 0.74和0.74、0.83和0.76、0.78和0.79、 0.83和0.79；SROC曲线下面积分别为： 0.8363、0.8820、0.8663和0.8719。结 论 DWI对肝纤维化分级具有较高的诊断效 能。

Objective A meta-analysis was performed to assess the diagnostic efficiency of DWI (diffusion-weighted imaging) for hepatic fibrosis stage assessment with MR imaging. Methods Online journal databases had been searched. Diagnostic tests of DWI for hepatic fibrosis stage assessment were included. Liver fibrosis was categorized by redistribution into five stages according to the histopathological description by Metavir, Scheuer and Batts-Ludwig score system. The quality of these studies were evaluated according to the QUADAS (Quality assessment of diagnostic accuracy studies) items. The Meta-analysis and the SROC (Summary receiver operating characteristic) curve were performed by Meta-Disc. Results Thirteen studies were identified which met the criteria could perform a meta-analysis. There were 809 cases involved in this study. Meta-analysis showed high heterogeneities among these studies. The pooled sensitivity of G1, G2, G3, G4 hepatic fibrosis stages were 0.74, 0.83, 0.78 and 0.83 respectively. The pooled specificity were 0.74, 0.76, 0.79and 0.79 respectively. The AUCs of SROC were 0.8363, 0.8820, 0.8663 and 0.8719 respectively. Conclusion DWI has a high diagnostic efficiency for staging hepatic fibrosis.