Koelemay M J, den Hartog D, Prins M H, Kromhout J G, Legemate D A, Jacobs M J
Department of Surgery, University of Amsterdam, Netherlands.
Br J Surg. 1996 Mar;83(3):404-9. doi: 10.1002/bjs.1800830336.
The development of duplex scanning carries the prospect of an entire non-invasive work-up of patients with peripheral arterial occlusive disease. To obtain the best available estimates of its diagnostic accuracy, a meta-analysis of 71 studies evaluating duplex scanning was performed. Independent methodological judgement left 16 studies for data extraction. Pooled estimates (95 per cent confidence interval of sensitivity and specificity for detection of a stenosis greater than or equal to 50 per cent or occlusion in the aortoiliac tract were 86 (80-91) per cent and 97 (95-99) per cent respectively. The results for the femoropopliteal tract compared well with this, with a sensitivity of 80 (74-85) per cent and a specificity of 96 (94-98) per cent. The accuracy of detection of a stenosis greater than or equal to 50 per cent or an occlusion in the infragenicular arteries was lower with a sensitivity and specificity of 83 (59-96) per cent and 84 (69-93) per cent respectively. Duplex scanning is an accurate tool for assessment of atherosclerotic lesions in the aortoiliac and femoropopliteal tract and can replace routine preinterventional angiography in a substantial number of patients.
双功扫描技术的发展为外周动脉闭塞性疾病患者带来了全面无创检查的前景。为了对其诊断准确性做出最佳评估，我们对71项评估双功扫描的研究进行了荟萃分析。经过独立的方法学判断，最终选取了16项研究进行数据提取。汇总估计值（检测主动脉髂动脉段狭窄大于或等于50%或闭塞的敏感性和特异性的95%置信区间）分别为86（80 - 91）%和97（95 - 99）%。股腘动脉段的结果与之相当，敏感性为80（74 - 85）%，特异性为96（94 - 98）%。检测膝下动脉狭窄大于或等于50%或闭塞的准确性较低，敏感性和特异性分别为83（59 - 96）%和84（69 - 93）%。双功扫描是评估主动脉髂动脉段和股腘动脉段动脉粥样硬化病变的准确工具，在相当数量的患者中可以取代常规的介入前血管造影检查。
