Department of Neurology, China-Japan Union Hospital of Jilin University, No.126 Xiantai Road, Nanguan District, Changchun, China.
Department of Emergency, The First Hospital of Zibo, Zibo, China.
J Neurol. 2022 Mar;269(3):1142-1153. doi: 10.1007/s00415-021-10540-7. Epub 2021 Apr 11.
The diagnostic value of non-contrast CT (NCCT) in acute stroke imaging remains indispensable, especially under emergency conditions with limited resources. The radiological conjugate eye deviation (RCED) has been demonstrated as a NCCT sign to predict acute ischemic stroke (AIS) or AIS secondary to large vessel occlusion (LVO) in recent studies. We performed a meta-analysis to gain a better understanding into the predictive role of RCED for AISs and LVO-AISs.
We conducted a systematic literature search using PubMed, Embase, and Cochrane. The search focused on studies published between January 2000 and August 2020 that reported the predictive value of RCED for the diagnosis of AIS or LVO-AIS. Principal measurements of the meta-analysis were the overall sensitivity, specificity, the positive likelihood ratio (PLR), and the negative likelihood ratio (NLR) of RCED in predicting AIS and LVO-AIS.
We included 11 studies (n = 2304). For AIS, RCED had a sensitivity of 0.37 (95% CI 0.27-0.47), a specificity of 0.86 (95% CI 0.73-0.93), the area under the receiver operating characteristic curve (AUC) was 0.58 (95% CI 0.53-0.62), PLR was 2.5 (95% CI 1.5-4.4), and NLR was 0.74 (95% CI 0.65-0.84). For LVO-AIS, RCED had a sensitivity of 0.63 (95% CI 0.46-0.77), a specificity of 0.77 (95% CI 0.71-0.82), AUC was 0.63 (95% CI 0.46-0.77), PLR was 2.7 (95% CI 1.7-4.3), and NLR was 0.49 (95% CI 0.3-0.78).
RCED can be used to predict LVO-AIS. It is expected that this method will be extensively used and validated in acute stroke imaging, especially under emergency conditions with limited resources.
在急性脑卒中成像中，非对比 CT（NCCT）的诊断价值仍然不可或缺，尤其是在资源有限的紧急情况下。最近的研究表明，放射共轭眼偏斜（RCED）是一种 NCCT 征象，可预测急性缺血性脑卒中（AIS）或大血管闭塞（LVO）引起的 AIS。我们进行了一项荟萃分析，以更好地了解 RCED 对 AIS 和 LVO-AIS 的预测作用。
我们使用 PubMed、Embase 和 Cochrane 进行了系统的文献检索。检索重点是 2000 年 1 月至 2020 年 8 月期间发表的报告 RCED 对 AIS 或 LVO-AIS 诊断预测价值的研究。荟萃分析的主要测量指标包括 RCED 预测 AIS 和 LVO-AIS 的总敏感性、特异性、阳性似然比（PLR）和阴性似然比（NLR）。
我们纳入了 11 项研究（n=2304）。对于 AIS，RCED 的敏感性为 0.37（95%CI 0.27-0.47），特异性为 0.86（95%CI 0.73-0.93），受试者工作特征曲线下面积（AUC）为 0.58（95%CI 0.53-0.62），PLR 为 2.5（95%CI 1.5-4.4），NLR 为 0.74（95%CI 0.65-0.84）。对于 LVO-AIS，RCED 的敏感性为 0.63（95%CI 0.46-0.77），特异性为 0.77（95%CI 0.71-0.82），AUC 为 0.63（95%CI 0.46-0.77），PLR 为 2.7（95%CI 1.7-4.3），NLR 为 0.49（95%CI 0.3-0.78）。
RCED 可用于预测 LVO-AIS。预计这种方法将在急性脑卒中成像中得到广泛应用和验证，尤其是在资源有限的紧急情况下。
