Coronary arteries: Diagnostic performance of 16-versus 64-section spiral CT compared with invasive coronary angiography-meta-analysis
Coronary arteries: Diagnostic performance of 16-versus 64-section spiral CT compared with invasive coronary angiography-meta-analysis
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DOI：
10.1148/radiol.2453061899
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发表时间：
2007-12-01
期刊：
影响因子：
19.7
通讯作者：
Hamon, Martial
中科院分区：
文献类型：
--
作者：
Hamon, Michele;Morello, Remy;Hamon, Martial
目的：进行荟萃分析，比较 16 断面与 64 断面计算机断层扫描 (CT) 诊断冠状动脉疾病 (CAD) 的诊断性能。材料和方法：在 MEDLINE 数据库中搜索相关原始文章。文章纳入标准为（a）使用多截面螺旋CT作为阻塞性CAD的诊断测试，（b）使用新一代多截面螺旋CT（16或64截面）扫描仪，以及（c）使用冠状动脉造影作为诊断阻塞性CAD的参考标准（选择> 50％直径狭窄作为诊断CAD的截止标准）。数据提取后，根据随机效应模型进行分析。研究间统计异质性也通过使用 Cochran Q X 2 检验进行评估。结果：在 328 篇确定的相关文章中，37 篇满足所有纳入标准，其中 28 篇的数据可用于基于患者的分析。基于患者的分析包括来自 16 项研究（对应于接受 16 断层螺旋 CT 的 1292 名患者）和 12 项研究（对应于接受 64 断层螺旋 CT 的 695 名患者）的汇总数据。 16 断面 CT 与 64 断面 CT 的结果灵敏度分别为 95%（95% 置信区间 [CI]：93%、96%）与 97%（95% CI：95%、98%）（P = 0.03）、69%（95% CI：66%、73%）与 90%（95% CI：86%）特异性 (P < .001) 为 93%)，阳性预测值 (PPV) 为 79% (95% CI: 76%, 82%) 与 93% (95% CI: 91%, 96%) (P < .001)，92% (95% CI: 88%, 94%) 与 96% (95% CI: 92%, 98%)阴性预测值 (P < .001)，诊断比值比 (P = .1) 为 72.05 (95% CI: 31.35, 165.56) 与 181.82 (95% CI: 88.70, 372.71)。结论：与 16 截面 CT 相比，64 截面螺旋 CT 在每个患者的基础上具有显着更高的特异性和 PPV。检测冠状动脉狭窄超过 50%。
Purpose: To perform a meta-analysis to compare the diagnostic performance of 16-versus64-section computed tomography (CT) for the diagnosis of coronary artery disease (CAD).Materials and Methods: The MEDLINE database was searched for relevant original articles. Criteria for inclusion of articles were (a) use of multisection spiral CT as a diagnostic test for obstructive CAD, (b) use of the newer generation of multisection spiral CT (16 or 64 section) scanners, and (c) use of coronary angiography as the reference standard for diagnosing obstructive CAD (> 50% diameter stenosis was selected as the cutoff criterion for diagnosis of CAD). After data extraction, the analysis was performed according to a random-effects model. Between-study statistical heterogeneity also was assessed by using Cochran Q X 2 tests.Results: Of 328 identified relevant articles, 37 fulfilled all inclusion criteria, with data available for a patient-based analysis in 28. The patient-based analysis included pooled data from 16 studies, corresponding to 1292 patients who underwent 16-section spiral CT, and from 12 studies, corresponding to 695 patients who underwent 64-section spiral CT. Respectively, the results for 16-section CT versus 64-section CT were 95% (95% confidence interval [CI]: 93%, 96%) versus 97% (95% CI: 95%, 98%) for sensitivity (P = .03), 69% (95% CI: 66%, 73%) versus 90% (95% CI: 86%, 93%) for specificity (P < .001), 79% (95% CI: 76%, 82%) versus 93% (95% CI: 91%, 96%) for positive predictive value (PPV) (P < .001), 92% (95% CI: 88%, 94%) versus 96% (95% CI: 92%, 98%) for negative predictive value (P < .001), and 72.05 (95% CI: 31.35, 165.56) versus 181.82 (95% CI: 88.70, 372.71) for diagnostic odds ratio (P = .1).Conclusion: Sixty-four-section spiral CT has significantly higher specificity and PPV on a per-patient basis compared with 16-section CT for the detection of greater than 50% stenosis of coronary arteries.