CTA对于诊断外伤性四肢动脉损伤的Meta分析  

CT angiography in the diagnosis of traumatic arterial injury of extremity:a Meta analysis

作　　者：胡磊[1] 查云飞[1] 邢栋[1] 王克军[1] 龚威[1] 闫立永 王娇[1] 林苑[1] 

机构地区：[1]武汉大学人民医院放射科,武汉430060

出　　处：《放射学实践》2015年第9期944-948,共5页Radiologic Practice

摘　　要：目的：探讨CTA 对急性四肢动脉损伤的诊断效果。方法：检索 PubMed、EBSCO、Cochrane Database Sys-tematic Reviews、CNKI等数据库，筛查相关研究文献，运用 QUSDAS-2工具对研究对象进行系统评价，提取纳入文献的真、假阳性数，真、假阴性数，进行异质性检测，合并统计量，绘制受试者工作特征曲线（SROC）。结果：本研究共纳入文献9篇，纳入文献均表现为较高质量、较低偏倚风险和临床适用性风险。合并灵敏度、特异度、阳性似然比、阴性似然比、诊断OR值分别为0．98（95％CI：0．96～1．00）、0．99（95％CI：0．97～1．00）、33．09（95％CI：15．75～69．53）、0．04（95％CI：0．02～0．07）、1100．47（95％CI：376．48～3216．73）。SROC下面积为0．99，Q 指数为0．9689。结论：CTA 对于创伤性四肢动脉损伤的诊断具有较高的敏感度和特异度，可以作为四肢外伤术前筛查血管损伤的有效方法。Objectives：To evaluate the diagnostic efficiency of CT angiography （CTA）in detecting acute traumatic arterial injury of extremity.Methods：Databases including PubMed,EBSCO,Cochrane library and CNKI were used for screening correlated literature.Using QUADAS 2 for systematic evaluation of the study.Data of true positive,false posi-tive,true negative,false negative in these literature were extracted for further heterogeneity study,statistical pooling and summary receiver operating characteristic curve （SROC）were analyzed.Results：Totally 9 pieces of literature met the stand-ard of high quality,relative low risk of deviation and risk for clinical application.The pooled sensitivity,specificity,PLR, NLR and Diagnosis OR values were 0.98 （95%CI：0.96~1.00）,0.99 （95%CI：0.97~1.00）,33.09 （95%CI：15.75~69. 53）,0.04（95%CI：0.02~0.07）and1100.47（95%CI：376.48~3216.73）,respectively.The area under SROC was 0.99 and the Q index was 0.9689.Conclusion：CTA has high sensitivity and specificity for the diagnosis of arterial injury in patients with extremity trauma and can be used as an effective screening modality for traumatic arterial injury of extremities.

关 键 词：CT血管成像 血管造影术 数字减影 创伤 动脉损伤 META分析 

分 类 号：R654.4[医药卫生—外科学] R816.8[医药卫生—临床医学]