ObjectiveTo conduct a meta-analysis comparing the accuracy of artificial intelligence (AI)-assisted diagnostic systems based on 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) and structural MRI (sMRI) in the diagnosis of Alzheimer's disease (AD). MethodsOriginal studies dedicated to the development or validation of AI-assisted diagnostic systems based on 18F-FDG PET/CT or sMRI for AD diagnosis were retrieved from the Web of Science, PubMed, and Embase databases. Studies meeting the inclusion criteria were collected, and the risk of bias and clinical applicability of the included studies were assessed using the PROBAST checklist. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve were calculated using a bivariate random-effects model. ResultsTwenty-six studies met the inclusion criteria, yielding a total of 38 2×2 contingency tables related to diagnostic performance. Specifically, 24 contingency tables were based on 18F-FDG PET/CT to distinguish AD patients from normal cognitive (NC) controls, and 14 contingency tables were based on sMRI for the same purpose. The meta-analysis results showed that for 18F-FDG PET/CT, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 89% (95%CI 88% to 91%), 93% (95%CI 91% to 94%), and 0.96 (95%CI 0.93 to 0.97), respectively. For sMRI, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 88% (95%CI 85% to 90%), 90% (95%CI 87% to 92%), and 0.94 (95%CI 0.92 to 0.96), respectively. ConclusionAI-assisted diagnostic systems based on either 18F-FDG PET/CT or sMRI demonstrated similar performance in the diagnosis of AD, with both showing high accuracy.
【摘要】 目的 探讨2型糖尿病合并下肢血管病变血管内介入治疗的临床意义。 方法 2009年1-5月对4例2型糖尿病合并下肢血管病变患者，根据血管狭窄情况选择不同介入治疗方式，行下肢动脉造影及动脉球囊扩张或支架成形术。 结果 4例患者均有表现静息痛及间歇性跛行，下肢血管超声显示糖尿病下肢动脉有不同程度的斑块、狭窄与血栓形成，病变累及下肢股动脉、髂动脉及胫前、足背动脉。介入治疗后患者下肢血管灌注得到明显改善，静息痛及间歇性跛行明显改善，皮温改善，需要截肢患者截肢平面显著降低。 结论 通过下肢血管DSA造影检查，准确了解糖尿病患者下肢血管的阻塞部位及程度，在保守治疗基础上选择不同方式的介入治疗，有助于下肢血管病变的明显改善。【Abstract】 Objective To investigate the clinical significance of intervention therapy for patients with type 2 diabetes combined with vascular lesions of lower extremities. Methods From January to May, 2009, four diabetic patients with vascular lesions of lower extremities were examined by Doppler ultrasonography and digital subtration angiography (DSA). All patients were treated by percutaneous transluminal angioplasty (PTA) or stenting therapy. Results Stenoses and obstruction of lower extremity blood vessels were observed in all patients. After intervention therapy, vascular perfusion of lower extremities was improved and signs of rest pain and intermittent claudication were relieved; the skin temperature was improved, and the amputation level was apparently decreased. Conclusion It suggests that DSA is effective in judging extend and location of blood vessel stenosis,and the interventional treatment could lead to a satisfying prognosis.