64层螺旋CT对椎动脉狭窄诊断价值的荟萃分析

目的 对64层螺旋CT血管造影(CTA)诊断椎动脉狭窄的文献进行荟萃分析,评价64层螺旋CTA对椎动脉狭窄的诊断价值.方法 以64层螺旋CT、血管造影、椎动脉狭窄等为检索词,检索Cochrane图书馆、PubMed、EBSCO、中国生物医学文献数据库、清华同方全文数据库等的中文和英文文献.对符合纳人标准的文献进行质量评估、异质性检验.汇总敏感性和特异性,通过汇总受试者工作特征曲线(SROC)和曲线下面积(AUC)以及诊断优势比(DROC)评价64层螺旋CT对椎动脉狭窄的诊断价值.结果 共纳入4篇中文文献,1篇A级,3篇B级.异质性检验发现纳入研究不存在异质性,采用固定效应模型计算.其中对椎动脉狭窄≥50%的汇总敏感性、特异性、DROC和SROC AUC分别为0.98(0.94～1.00)、0.93(0.89～0.96),526.33和0 9899;对椎动脉狭窄≥70%分别为0.98(0 91～1.00)、0.97(0.94～0.99),838.40和0.9932.结论 64层螺旋CTA诊断椎动脉狭窄有较高的敏感性和特异性.但还需要高质量的前瞻性研究以更准确地评价其临床价值.

Abstract：

Objective To evaluate the diagnostic value of 64-slice spiral computed tomographic angiography (CTA) in vertebral artery stenosis through a meta-analysis of the relevant data. Methods A database search of Cochrane Library, PubMed, EBSCO, CBM-disc and CNKI was performed to identify the relevant English and Chinese language articles with such keywords as 64-slice computer tomography,angiography and vertebral artery stenosis. Quality evaluation, heterogeneity test and sensitivity and specificity to the qualified original data were conducted. Summary receiver operating characteristic (SROC)curve, the area under curve (AUC) and diagnostic odds ratio (DROC) were also calculated. Results A total of 4 studies were eligible for meta-analysis. Among them, 1 was graded as A and 3 were graded as B.No heterogeneity was found based upon a fixed effect model. For vertebral artery stenosis ≥50% , the pooled weighted sensitivity, specificity, DROC and SROC AUC was 0.98 (0.94-1.00) , 0.93 (0.89-0.96) ,526.33 and 0.9899 respectively; while for vertebral artery stenosis ≥50% , the parameters were 0.98(0.91-1.00), 0.97 (0.94-0.99), 838.40 and 0.9932 respectively. Conclusions 64-slice spiral CTA has such a high level of accuracy, sensitivity and specificity in the non-invasive diagnosis of vertebral artery stenosis.

Diagnostic value of 64-slice spiral computed tomograhic angiography in vertebral artery stenosis: a meta-analysis

Objective To evaluate the diagnostic value of 64-slice spiral computed tomographic angiography (CTA) in vertebral artery stenosis through a meta-analysis of the relevant data. Methods A database search of Cochrane Library, PubMed, EBSCO, CBM-disc and CNKI was performed to identify the relevant English and Chinese language articles with such keywords as 64-slice computer tomography,angiography and vertebral artery stenosis. Quality evaluation, heterogeneity test and sensitivity and specificity to the qualified original data were conducted. Summary receiver operating characteristic (SROC)curve, the area under curve (AUC) and diagnostic odds ratio (DROC) were also calculated. Results A total of 4 studies were eligible for meta-analysis. Among them, 1 was graded as A and 3 were graded as B.No heterogeneity was found based upon a fixed effect model. For vertebral artery stenosis ≥50% , the pooled weighted sensitivity, specificity, DROC and SROC AUC was 0.98 (0.94-1.00) , 0.93 (0.89-0.96) ,526.33 and 0.9899 respectively; while for vertebral artery stenosis ≥50% , the parameters were 0.98(0.91-1.00), 0.97 (0.94-0.99), 838.40 and 0.9932 respectively. Conclusions 64-slice spiral CTA has such a high level of accuracy, sensitivity and specificity in the non-invasive diagnosis of vertebral artery stenosis.