Meta分析评价双能量头颅CTA诊断颅内动脉瘤准确性  

Diagnostic accuracy of dual-energy CT angiography in patients with intracranial aneurysm:Meta-analysis

作　　者：王茂雪 李明泉 罗松[3] 

机构地区：[1]泰康仙林鼓楼医院医学影像科,江苏南京210046 [2]泰康仙林鼓楼医院神经内科,江苏南京210046 [3]南京总医院/南京大学附属金陵医院医学影像科,江苏南京210002

出　　处：《中国医学影像技术》2018年第1期35-38,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用Meta分析评价头颅双能量CTA对颅内动脉瘤的诊断价值。方法以"双能量""颅内动脉瘤"或"蛛网膜下腔出血"为检索词检索万方医药数据库、中国期刊全文数据库、中国生物医学文献数据库;以"dual energy""intracranial aneurysms"或"subarachnoid hemorrhage"为检索词检索Pubmed数据库,时间为2006年1月—2017年1月,纳入以DSA为金标准的双能量CTA诊断颅内动脉瘤文献,对最后纳入文献进行质量评价和数据提取,采用MetaDISC1.4软件进行分析,检验各研究间的异质性,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分析。结果纳入符合标准的文献15篇,无异质性。计算效应合并值,CTA诊断颅内动脉瘤合并敏感度为0.97[95%CI(0.96,0.99)],合并特异度为0.99[95%CI(0.97,1.00)],合并阳性似然比为21.71[95%CI(12.10,38.96)],合并阴性似然比为0.04[95%CI(0.03,0.07)],合并OR值为703.4[95%CI(303.96,1 627.74)];合并ROC曲线下面积为0.990 8,敏感度与特异度交点最大值(Q值)为0.992 5。结论双能量CTA对诊断颅内动脉瘤具有较高的敏感度和特异度,可作为疑似颅内动脉瘤患者的首选检查。Objective To explore the diagnostic value of dual-energy CTA in detection of intracranial aneurysms by using Meta-analysis. Methods Taking ＂Dual energy＂,＂intracranial aneurysms＂ or ＂subarachnoid hemorrhage＂ as key words, related literatures of diagnostic accuracy of intracraniaI aneurysms by using dual-energy CTA compared with DSA were extracted from Wanfang database, CNKI, Chinese biomedical database and PubMed from January 2006 to January 2017. The quality of included literatures was assessed. MetaDISC1.4 was used for Meta-analysis to examine the heterogeneity among the studies and to analyze the diagnostic accuracy index. The forest map was drawn. The summary operating characteristic curve was analyzed. Results Fifteen studies without heterogeneity were considered for analysis. The pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio was 0.97 （95 % CI [,0.96, 0.99]）, 0.99 （95 % CI[0.97, 1.00]）, 21.71 （95%CI [12.10, 38.96]） and0.04 （95%CI [0. 03, 0.07]）, respectively. The value of OR was 703.4 （95%CI [-303.96, 1 627.74]）. The area under the curve of summary ROC was 0. 990 8. The maximum value （Q value） of sensitivity and specificity was 0. 992 5. Conclusion Dual-energy CTA has high sensitivity and specificity in diagnosis of intracranial aneurysms, therefore can be taken as the first choice for patients with suspected intracranial aneurysms.

关 键 词：动脉瘤 体层摄影术 X线计算机 血管造影术 Meta分析 

分 类 号：R543.5[医药卫生—心血管疾病] R814.42[医药卫生—内科学]