Predictive Validity of Hypodensities on Noncontrast Computed Tomography for Hematoma Growth in Intracerebral Hemorrhage: a Meta-Analysis.
Predictive Validity of Hypodensities on Noncontrast Computed Tomography for Hematoma Growth in Intracerebral Hemorrhage: a Meta-Analysis.
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DOI：
10.1016/j.wneu.2018.11.239
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发表时间：
2019-03
影响因子：
2
通讯作者：
Zhiyuan Yu;Jun Zheng;Lu Ma;Rui Guo;C. You;Hao Li
中科院分区：
文献类型：
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作者：
Zhiyuan Yu;Jun Zheng;Lu Ma;Rui Guo;C. You;Hao Li
目的脑出血是一种死亡率高的脑卒中类型。血肿生长（HG）发生在大约三分之一的脑出血患者中，并且与预后不良独立相关。先前的研究表明，非对比计算机断层扫描的一项指标，称为低密度，可以预测脑出血患者的HG。因此，本研究旨在评估该标记的预测有效性。方法在不受语言限制的情况下，检索文献数据库，对ICH的低密度和HG进行原始调查。数据提取，研究质量由2位评论者独立评估。获得合并敏感性、特异性、阳性似然比（LR）、阴性似然比（LR）、诊断优势比及其95%置信区间（ci）。描述了一个总结的接收机工作特性曲线。结果本荟萃分析纳入了4项研究的5个队列，共2157例患者。合并敏感性为0.58 (95% CI 0.46 ~ 0.68)，合并特异性为0.71 （95% CI 0.62 ~ 0.79）。此外，合并阳性LR为2.0 (95% CI 1.6-2.5)，合并阴性LR为0.60 （95% CI 0.49-0.73）。合并诊断优势比为3 (95% CI 2-5)，总受试者工作特征曲线下面积为0.69 （95% CI 0.65-0.73）。结论本研究提示，尽管在目前的研究中，其综合预测值不太令人满意，但非对比ct低密度成像可以帮助预测HG。低密度在预测HG中的作用有待进一步研究证实。
ObjectiveIntracerebral hemorrhage (ICH) is a type of stroke that leads to high mortality. Hematoma growth (HG) happens in about one third of all patients with ICH and is independently related to poor outcome. Previous studies have shown that an indicator on noncontrast computed tomography, called hypodensities, can predict HG in patients with ICH. Thus, this study was done to assess the predictive validity of this marker.MethodsBibliographic databases were searched, without language restriction, for original investigation on hypodensities and HG in ICH. Data were extracted, and study quality was assessed by 2 reviewers independently. Pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio, and their 95% confidence intervals (CIs) were obtained. A summary receiver operating characteristic curve was depicted.ResultsFive cohorts with 2157 patients in 4 studies were included in the present meta-analysis. The pooled sensitivity was 0.58 (95% CI 0.46–0.68) and the pooled specificity was 0.71 (95% CI 0.62–0.79). In addition, the pooled positive LR was 2.0 (95% CI 1.6–2.5) and the pooled negative LR was 0.60 (95% CI 0.49–0.73). The pooled diagnostic odds ratio was 3 (95% CI 2–5) and the area under summary receiver operating characteristic curve was 0.69 (95% CI 0.65–0.73).ConclusionsThis study suggests that hypodensities on noncontrast computed tomography can be helpful in HG prediction, although its pooled predictive values are not very satisfying in the current study. The role of hypodensities in predicting HG should be confirmed by further studies.