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目的通过Meta分析,比较CT血管成像(CTA)与MR血管成像(MRA)对颅内动脉瘤的诊断价值。方法检索维普中文科技期刊数据库、中国生物医学文献数据库、中国期刊全文数据库、数字化期刊数据库、PubMed、EMBASE、Web of Science、Cochrane Library,按照纳入标准筛选关于CTA和MRA对颅内动脉瘤诊断的研究,检索时间均由建库至2012年4月。采用Metadisc 1.4软件对数据进行分析,计算诊断的敏感度、特异度、比值比(OR)及95%CI,异质性采用I2检验分析,绘制出汇总受试者工作特征曲线(SROC),并计算曲线下面积。结果共纳入6篇符合标准的文章(均为前瞻性研究),合计370例患者。Meta分析结果示,CTA对颅内动脉瘤诊断的敏感度为0.91(95%CI:0.87～0.94),特异度为0.92(95%CI:0.86～0.96),OR为78.29(95%CI:28.27～216.77),SROC曲线下面积为0.9593。MRA诊断的敏感度为0.85(95%CI:0.80～0.89),特异度为0.92(95%CI:0.86～0.96),OR为41.94(95%CI:18.50～95.09),SROC曲线下面积为0.9304。结论 CTA对于颅内动脉瘤的诊断价值高于MRA。但仍需大样本的研究进一步加以证实。
Objective To compare the diagnostic value of CT angiography (CTA) and MR angiography (MRA) for intracranial aneurysms by Meta-analysis. Methods To search for the diagnosis of intracranial aneurysms based on CTA and MRA in PubMed, EMBASE, Web of Science and Cochrane Library, according to the inclusion criteria of Chinese VIP database, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Digital Periodical Database , Search time from building to April 2012. Metadisc 1.4 software was used to analyze the data to calculate the diagnostic sensitivity, specificity, odds ratio (OR) and 95% CI. Heterogeneity was assessed by I2 test, and the summary receiver operating characteristic curve (SROC) was drawn. Calculate the area under the curve. Results A total of 6 eligible articles were included (all prospective studies) for a total of 370 patients. Meta-analysis showed that the sensitivity of CTA to the diagnosis of intracranial aneurysms was 0.91 (95% CI: 0.87-0.94), specificity was 0.92 (95% CI: 0.86-0.96), and OR was 78.29 (95% CI: 28.27 ~ 216.77), the area under the SROC curve is 0.9593. The sensitivity of MRA was 0.85 (95% CI: 0.80-0.89), specificity was 0.92 (95% CI: 0.86-0.96), OR was 41.94 (95% CI: 18.50-95.09), and the area under the SROC curve was 0.9304 . Conclusion The diagnostic value of CTA for intracranial aneurysms is higher than that of MRA. But still need a large sample of the study to be further confirmed.