64层螺旋CT对椎动脉狭窄诊断价值的Meta分析.doc

64层螺旋CT对椎动脉狭窄诊断价值的Meta分析 [摘要] 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Meta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。对符合纳入标准的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，均为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。 但由于本系统评价纳入的随机对照试验数目不多,有必要开展更多设计严谨,大样本、多中心的随机对照试验来确证这种趋势。 64 slice spiral CT angiography in diagnosis of vertebral artery stenosis: a Meta analysis WU Li-ya1, QIN Chao1, MEI Yu-jia1, YE Zi-ming1, ZHOU Hong2, HU Bang-li3 1 Department of Neurology, 2 Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021 China; 3 Guangxi Medical Information Institute, Nanning 530022, China. [Abstract] Objective To evaluate the value of 64 slice spiral CT angiography (CTA) in diagnosis of vertebral artery stenosis by using Meta analysis for the related data. Methods A search in Cochrane Library, PubMed, EBSCO, CBM-disc, and CNKI was performed to identify relevant English and Chinese 1anguage articles with the keywords including 64 slice computer tomography, angiography, and vertebral artery stenosis. We conducted quality evaluation and heterogeneity test and sensitivity and specificity to the qualified original data. Summary Receiver Operating Characteristic (SROC) curve and the area under the curve (AUC), diagnosis OR was also calculated. Results A total of 4 studies were eligible for Meta analysis and all graded as B. No heterogeneity was found and fixed effect model was using. 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)，526.330.9899, respectively; while for vertebral artery stenosis ≥50%, the parameters was 0.98(0.91~1.00), 0.97(0.94