计算机断层扫描灌注成像对急性脑卒中患者的诊断准确性：一项荟萃分析。

Diagnostic accuracy of computed tomography perfusion in patients with acute stroke: A meta-analysis.

作者信息

Xin Ye, Han Fu-Gang

机构信息

The Department of Radiology, First Affiliated Hospital of Sichuan Medical University (formerly Luzhou Medical College Hospital), Jiangyang District, Luzhou 646000, Sichuan, China.

出版信息

J Neurol Sci. 2016 Jan 15;360:125-30. doi: 10.1016/j.jns.2015.11.046. Epub 2015 Nov 25.

DOI:10.1016/j.jns.2015.11.046

PMID:26723988

Abstract

PURPOSE

The purpose of this meta-analysis was to evaluate the sensitivity and specificity of computed tomography perfusion (CTP) in diagnosing acute ischemic stroke in patients presenting to the emergency department with stroke-like symptoms.

METHODS

Medline, Cochrane, EMBASE, and Google Scholar databases were searched until November 5, 2014 using the following terms: magnetic resonance imaging/MRI, computed tomography/CT, and stroke. Randomized controlled trials, retrospective, and case-controlled studies were included which evaluated patients who presented for emergency assessment of stroke-like systems. Diffusion weighted imaging (DWI) was used as reference standard. Only studies published in English or Chinese were included. Quality assessment and sensitivity analysis were performed to evaluate that strength of the data.

RESULTS

The analysis included six studies with a total of 1429 patients. The pooled overall sensitivity for CTP indicated it had reasonable sensitivity (55.7%) and high specificity (92%). Subgroup analysis indicated that of the different CTP modes, MTT and CBF had higher sensitivities (48.6% and 47.3%, respectively) than CBV (26.3%). CBF and CBV had higher specificity (91.0% and 95.4%, respectively) compared with MTT (86.6%).

CONCLUSION

All three CTP modes had adequate sensitivity but very high specificity, and among the three CTP modes, CBF had the best diagnostic characteristics.

摘要

目的

本荟萃分析旨在评估计算机断层扫描灌注成像（CTP）对急诊科出现类似中风症状患者诊断急性缺血性中风的敏感性和特异性。

方法

检索Medline、Cochrane、EMBASE和谷歌学术数据库至2014年11月5日，检索词如下：磁共振成像/MRI、计算机断层扫描/CT和中风。纳入随机对照试验、回顾性研究和病例对照研究，这些研究评估了因类似中风症状前来进行急诊评估的患者。弥散加权成像（DWI）用作参考标准。仅纳入以英文或中文发表的研究。进行质量评估和敏感性分析以评估数据的强度。

结果

该分析纳入了6项研究，共1429例患者。CTP的汇总总体敏感性表明其具有合理的敏感性（55.7%）和较高的特异性（92%）。亚组分析表明，在不同的CTP模式中，平均通过时间（MTT）和脑血流量（CBF）的敏感性（分别为48.6%和47.3%）高于脑血容量（CBV，26.3%）。与MTT（86.6%）相比，CBF和CBV具有更高的特异性（分别为91.0%和95.4%）。