多层螺旋CT血管造影对颅内动脉瘤诊断价值的Meta分析  

Multi-slice CT Angiography for the Diagnosis of Intracranial Aneurysms: a Meta Analysis

作　　者：齐晨晖[1] 赵庆[1] 王红梅[1] 

机构地区：[1]焦作市第二人民医院,河南焦作454000

出　　处：《中国医学影像学杂志》2012年第12期948-952,共5页Chinese Journal of Medical Imaging

摘　　要：目的对多层螺旋CT血管造影(CTA)诊断颅内动脉瘤的文献进行荟萃分析,评价多层螺旋CTA对颅内动脉瘤的诊断价值。资料与方法以多层螺旋CT、CT血管造影、数字血管减影血管造影、颅内动脉瘤为检索词,检索PubMed、EBSCO、Springer、中国知网(CNKI)以及Cochrane图书馆数据库,文献检索时间2005-01～2011-01,同时检索纳入文献的参考文献。纳入探讨以数字减影血管造影(DSA)为"金标准"的关于CTA诊断颅内动脉瘤的文献,进行质量评价和资料提取,检验研究间的异质性,对诊断准确度指标进行Meta分析,绘制森林图,并进行综合受试者工作特征曲线(SROC)分析。结果符合纳入标准的文献共25篇,各研究之间存在低度异质性,按照随机效应模型计算汇总敏感度、特异度与诊断优势比分别为0.96(95%CI:0.95～0.97)、1.00(95%CI:1.00～1.00);SROC下面积为0.9988,Q指数为0.9894。结论多层螺旋CTA诊断颅内动脉瘤具有较高的敏感度及特异度,与DSA诊断价值相当,在颅内动脉瘤的筛查与诊断中具有重要临床意义。Purpose To evaluate the diagnostic value of multi-slice spiral CTA in intracranial aneurysms through meta-analysis of relevant literature. Materials and Methods Studies were located through electronic searching of the PubMed, EBSCO, Springer, CNKI, Cochrane library （from January 2005 to January 2011）, the key words： multi-slice spiral computer, multi-row spiral computer, computed angiography, intracranial aneurysm, digital subtraction angiography. Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of intracranial aneurysm using CTA were searched and reviewed. Studies with DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC were analyzed. Results Totally 25 studies met the inclusion criteria. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity were 0.96 （95% CI： 0.95-0.97）, 1.00 （95% CI： 1.00-1.00）, respectively; the area under of SROC curve was 0.9988 and the Q index was 0.9894. Conclusion Multi-slice spiral CTA has high sensitivity and specificity for diagnosing intracranial aneurysms and has considerable value with the DSA. It has important clinical value in screening and diagnosing intracranial aneurysms.

关 键 词：颅内动脉瘤 体层摄影术 螺旋计算机 脑血管造影术 META分析 

分 类 号：R739.4[医药卫生—肿瘤] R730.42[医药卫生—临床医学]