Role of non-contrast balanced steady-state free precession megnetic resonance angiography compared to contrast-enhanced megnetic resonance angiography in diagnosing renal artery stenosis： a meta-analysis  

作　　者：Tao Weijing Shen Yang Guo Lili Bo Genji 

机构地区：[1]Department of Radiology Huai'an First People'sHospital, Nanjing Medical University, Huai'an, Jiangsu 223300,China [2]Departmentof Public Health and Nutrition , Huai'an First People'sHospital, Nanjing Medical University, Huai'an, Jiangsu 223300,China

出　　处：《Chinese Medical Journal》2014年第19期3483-3490,共8页中华医学杂志（英文版）

摘　　要：Background Balanced steady-state free precession MR angiography （b-SSFP MRA） has shown great promise in diagnosing renal artery stenosis （RAS） as a non-contrast MR angiography （NC-MRA） method. However, results from related studies are inconsistent. The purpose of this meta-analysis was to assess the accuracy of b-SSFP MIRA compared to contrast-enhanced MR angiography （CE-MRA） in diagnosing RAS. Methods English and Chinese studies that were published prior to September 4, 2013 and that assessed b-SSFP MRA diagnostic performance in RAS patients were reviewed. Quality of the literature was assessed independently by two observers. The statistical analysis was adopted by the software of Meta-Disc version 1.4. Using the heterogeneity test, a statistical effect model was chosen to calculate different pooled weighted values. The receiver operator characteristic （ROC） space and Spearman correlation coefficient were to explore threshold effect. Sensitivity analysis and the publication bias were performed to demonstrate if the pooled estimates were stable and reliable. We produced forest plots to calculate the pooled values and corresponding 95% confidence interval （Cl） of sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, diagnostic odds ratio （DOR）, and constructed a summary receiver operating characteristic curve （SROC） to calculate the area under the curve （AUC）. Results A total of 10 high quality articles were used in this meta-analysis. The studies showed a high degree of heterogeneity. The ＂shoulder-arm＂ shape in the ROC plot and the Spearman correlation coefficient between the log（SEN） and Iog（1-SPE） suggested that there was a threshold effect. Sensitivity analysis demonstrated that the actual combined effect size was equal to the theoretical combined effect size. The publication bias was low after quality evaluation of the literature and the construction of a funnel plot. The pooled sensitivity was 0.88 （95% CI, 0.83-Background Balanced steady-state free precession MR angiography （b-SSFP MRA） has shown great promise in diagnosing renal artery stenosis （RAS） as a non-contrast MR angiography （NC-MRA） method. However, results from related studies are inconsistent. The purpose of this meta-analysis was to assess the accuracy of b-SSFP MIRA compared to contrast-enhanced MR angiography （CE-MRA） in diagnosing RAS. Methods English and Chinese studies that were published prior to September 4, 2013 and that assessed b-SSFP MRA diagnostic performance in RAS patients were reviewed. Quality of the literature was assessed independently by two observers. The statistical analysis was adopted by the software of Meta-Disc version 1.4. Using the heterogeneity test, a statistical effect model was chosen to calculate different pooled weighted values. The receiver operator characteristic （ROC） space and Spearman correlation coefficient were to explore threshold effect. Sensitivity analysis and the publication bias were performed to demonstrate if the pooled estimates were stable and reliable. We produced forest plots to calculate the pooled values and corresponding 95% confidence interval （Cl） of sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, diagnostic odds ratio （DOR）, and constructed a summary receiver operating characteristic curve （SROC） to calculate the area under the curve （AUC）. Results A total of 10 high quality articles were used in this meta-analysis. The studies showed a high degree of heterogeneity. The ＂shoulder-arm＂ shape in the ROC plot and the Spearman correlation coefficient between the log（SEN） and Iog（1-SPE） suggested that there was a threshold effect. Sensitivity analysis demonstrated that the actual combined effect size was equal to the theoretical combined effect size. The publication bias was low after quality evaluation of the literature and the construction of a funnel plot. The pooled sensitivity was 0.88 （95% CI, 0.83-

关 键 词：balanced steady-state free precession MR angiography renal artery stenosis META-ANALYSIS 

分 类 号：O482.531[理学—固体物理] X503.1[理学—物理]