The Performance of CT versus MRI in the Differential Diagnosis of Cerebral Venous Thrombosis
The Performance of CT versus MRI in the Differential Diagnosis of Cerebral Venous Thrombosis
复制标题
CT与MRI在脑静脉血栓鉴别诊断中的表现
DOI：
10.1055/s-0038-1642636
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发表时间：
2018-06-01
影响因子：
6.7
通讯作者：
Shao, Anwen
中科院分区：
文献类型：
--
作者：
Xu, Weilin;Gao, Liansheng;Shao, Anwen
研究背景脑静脉血栓形成（CVT）是一种少见的疾病，预后差。计算机断层扫描（CT）和磁共振成像（MRI）是非特异性神经系统症状患者最常用的成像方式。我们在这里提出一个荟萃分析，以评估CT和MRI在CVT和脑静脉窦血栓形成（CVST.Materials and Methods）的鉴别诊断的准确性进行了全面的检索PubMed，EMBASE，Web of Science，科克伦数据库和中国生物医学（CBM）数据库之前，2017年3月20日。在这份报告中，我们单独评估每篇文章的方法学质量，并进行荟萃分析，以获得正确识别CVT和CVST.Results 24个合格的文章，包括48项研究（4,595例）的诊断准确性的总结。CT-CVT/CT-CVST组的合并灵敏度为0.79（95%置信区间[CI]：0.76，0.82）/0.81（95% CI：0.78，0.84），合并特异性为0.90（95% CI：0.89，0.91）/0.89（0.88，0.91），汇总受试者操作特征（SROC）的曲线下面积（AUC）分别为0.9314/0.9161。每项研究均未观察到显着的异质性和发表偏差。对于MRI-CVT/MRI-CVST，合并灵敏度为0.82（95% CI：0.78，0.85）/0.80（95% CI：0.76，0.83），合并特异性为0.92（95%置信区间：0.91，0.94）/0.91（0.89，0.92），SROC的AUC为0.9221/0.9273，结论该Meta数据分析表明，CT和MRI对CVT和CVST的鉴别诊断具有较高的准确性，与分期、分析对象和分析方法无关。它们可以作为诊断CVT和CVST的替代次优金标准，特别是在紧急情况下。
Background Cerebral venous thrombosis (CVT) is a rare disease, and with poor prognosis. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used image modalities for patients with non-specific neurologic symptoms. We present here a meta-analysis to assess the accuracy of CT and MRI in the differential diagnosis of CVT and cerebral venous sinus thrombosis (CVST).Materials and Methods A comprehensive search of the PubMed, EMBASE, Web of Science, Cochrane Database and Chinese Biomedical (CBM) databases was conducted prior to March 20, 2017. In this report, we assess the methodological quality of each article individually and perform a meta-analysis to obtain the summary of the diagnostic accuracy of CT and MRI in correctly identifying CVT and CVST.Results Twenty-four eligible articles comprising 48 studies (4,595 cases) were included. The pooled sensitivity for CT-CVT/CT-CVST groups is 0.79 (95% confidence interval [CI]: 0.76, 0.82)/0.81(95% CI: 0.78, 0.84), and pooled specificity is 0.90 (95% CI: 0.89, 0.91)/0.89 (0.88, 0.91), with an area under the curve (AUC) for the summary receiver operating characteristic (SROC) of 0.9314/0.9161, respectively. No significant heterogeneity and publication bias was observed across each study. For MRI-CVT/MRI-CVST, the pooled sensitivity is 0.82 (95% CI: 0.78, 0.85)/0.80 (95% CI: 0.76, 0.83), and pooled specificity is 0.92 (95% CI: 0.91, 0.94)/0.91(0.89, 0.92), with an AUC for the SROC of 0.9221/0.9273, respectively.Conclusion This meta-analysis indicates that both CT and MRI have a high level of diagnostic accuracy in the differential diagnosis of CVT and CVST, independent of stage, target for analysis or analysis methods. They could be chosen as alternative sub-optimal gold standards for diagnosing CVT and CVST, especially in emergency.