Guo Wei, He Xu-Ying, Li Xi-Feng, Qian Dong-Xiang, Yan Jian-Quan, Bu De-Lin, Duan Chuan-Zhi
Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China; Department of Neurosurgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, PR China.
Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China.
J Neurol Sci. 2014 Nov 15;346(1-2):197-203. doi: 10.1016/j.jns.2014.08.023. Epub 2014 Aug 27.
Imaging methods are essential in evaluating cerebral artery aneurysms and they have evolved with recent technical advances. Sixty-four-row multi-section computed tomography (64-MSCT) angiography and three-dimensional digital subtraction angiography (3D-DSA) are two of the most popular methods. We sought to systematically explore and find out which one would be better in imaging cerebral artery aneurysm, and try to investigate the potential use and value of 64-MSCT angiography and 3D-DSA in cerebral artery aneurysm.
Followed by a predefined comprehensive literature search, we carefully searched both English and Chinese electronic databases for potentially relevant studies following our meta-analysis. Two reviewers independently assessed the methodological quality of the included eligible trials based on quality assessment of studies of diagnostic accuracy studies (QUADAS). Pooled summary statistics for sensitivity, specificity, positive and negative likelihood ratios (positive LR and negative LR), and diagnostic odds ratio (ORs) with their 95% confidence intervals (CIs) were utilized.
Final meta-analysis of 923 cerebral artery aneurysm cases were incorporated from eight cohort studies and selected for statistical analysis. Pooled sensitivity and specificity of 64-MSCT angiography in the diagnosis of cerebral artery aneurysm were 0.97 (95% CI, 0.96-0.98) and 0.91 (0.88-0.94), respectively. The pooled positive LR was 7.68 (95% CI, 3.34-17.67); and the pooled negative LR was 0.04 (95% CI, 0.03-0.05). The pooled diagnostic OR was 263.69 (95% CI, 121.19-573.77). The area under the SROC curve was 0.9934 (standard error [SE] = 0.0031). No significant evidence of publication bias was detected (P > 0.05).
The main finding of our meta-analysis revealed that 64-MSCT angiography relative to the 3D-DSA may have a high diagnostic accuracy for the cerebral artery aneurysm. Thus, 64-MSCT angiography may be an effective tool for the early detection of cerebral artery aneurysm.
成像方法在评估脑动脉瘤中至关重要，且随着近期技术进步不断发展。64排多层螺旋计算机断层扫描（64-MSCT）血管造影和三维数字减影血管造影（3D-DSA）是两种最常用的方法。我们试图系统地探究并找出哪种方法在脑动脉瘤成像方面更优，并探讨64-MSCT血管造影和3D-DSA在脑动脉瘤中的潜在用途和价值。
在进行预定义的全面文献检索后，我们按照荟萃分析的要求，仔细检索了英文和中文电子数据库，以查找潜在相关研究。两名评价者根据诊断准确性研究质量评估（QUADAS）独立评估纳入的合格试验的方法学质量。使用敏感性、特异性、阳性和阴性似然比（阳性LR和阴性LR）以及诊断比值比（OR）及其95%置信区间（CI）的合并汇总统计量。
最终的荟萃分析纳入了来自八项队列研究的923例脑动脉瘤病例，并进行统计分析。64-MSCT血管造影诊断脑动脉瘤的合并敏感性和特异性分别为0.97（95%CI，0.96 - 0.98）和0.91（0.88 - 0.94）。合并阳性LR为7.68（95%CI，3.34 - 17.67）；合并阴性LR为0.04（95%CI，0. — 0.05）。合并诊断OR为263.69（95%CI，121.19 - 573.77）。SROC曲线下面积为0.9934（标准误[SE]=0.0031）。未检测到明显的发表偏倚证据（P>0.05）。
我们荟萃分析的主要发现表明，相对于3D-DSA，64-MSCT血管造影对脑动脉瘤可能具有较高的诊断准确性。因此，64-MSCT血管造影可能是早期检测脑动脉瘤的有效工具。
Zotero 插件