دورية أكاديمية
Diagnostic accuracy of computed tomography angiography (CTA) for diagnosing blunt cerebrovascular injury in trauma patients: a systematic review and meta-analysis.
العنوان: | Diagnostic accuracy of computed tomography angiography (CTA) for diagnosing blunt cerebrovascular injury in trauma patients: a systematic review and meta-analysis. |
---|---|
المؤلفون: | Kik CC; Department of Neurosurgery, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584DX, Utrecht, The Netherlands., Slooff WM; Department of Neurosurgery, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584DX, Utrecht, The Netherlands. W.B.M.Slooff@umcutrecht.nl., Moayeri N; Department of Neurosurgery, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584DX, Utrecht, The Netherlands., de Jong PA; Department of Radiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands., Muijs SPJ; Department of Orthopaedic Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands., Öner FC; Department of Orthopaedic Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands. |
المصدر: | European radiology [Eur Radiol] 2022 Apr; Vol. 32 (4), pp. 2727-2738. Date of Electronic Publication: 2021 Dec 02. |
نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
اللغة: | English |
بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1991- |
مواضيع طبية MeSH: | Cerebrovascular Trauma*/diagnostic imaging , Wounds, Nonpenetrating*/diagnostic imaging, Angiography, Digital Subtraction/methods ; Cerebral Angiography ; Computed Tomography Angiography ; Humans ; Sensitivity and Specificity |
مستخلص: | Objectives: Previous literature showed that the diagnostic accuracy of computed tomographic angiography (CTA) is not equally comparable with that of the rarely used golden standard of digital subtraction angiography (DSA) for detecting blunt cerebrovascular injuries (BCVI) in trauma patients. However, advances in CTA technology may prove CTA to become equally accurate. This study investigated the diagnostic accuracy of CTA in detecting BCVI in comparison with DSA in trauma patients. Methods: An electronic database search was performed in PubMed, EMBASE, and Cochrane Library. Summary estimates of sensitivity, specificity, positive and negative likelihood, diagnostic odds ratio, and 95% confidence intervals were determined using a bivariate random-effects model. Results: Of the 3293 studies identified, 9 met the inclusion criteria. Pooled sensitivity was 64% (95% CI, 53-74%) and specificity 95% (95% CI, 87-99%) The estimated positive likelihood ratio was 11.8 (95%, 5.6-24.9), with a negative likelihood ratio of 0.38 (95%, 0.30-0.49) and a diagnostic odds ratio of 31 (95%, 17-56). Conclusion: CTA has reasonable specificity but low sensitivity when compared to DSA in diagnosing any BCVI. An increase in channels to 64 slices did not yield better sensitivity. There is a risk for underdiagnosis of BCVI when only using DSA to confirm CTA-positive cases, especially in those patients with low-grade injuries. Key Points: • Low sensitivity and high specificity were seen in identifying BCVI with CTA as compared to DSA. • Increased CTA detector channels (≤ 64) did not lead to higher sensitivity when detecting BCVI. • The use of CTA instead of DSA may lead to underdiagnosis and, consequently, undertreatment of BCVI. (© 2021. The Author(s).) |
References: | Debette S, Leys D (2009) Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol 8:668–678. (PMID: 10.1016/S1474-4422(09)70084-5) Rutman AM, Vranic JE, Mossa-Basha M (2018) Imaging and management of blunt cerebrovascular injury. Radiographics 38:542–563. (PMID: 10.1148/rg.2018170140) Esnault P, Cardinale M, Boret H et al (2017) Blunt cerebrovascular injuries in severe traumatic brain injury: Incidence, risk factors, and evolution. J Neurosurg 127:16–22. (PMID: 10.3171/2016.4.JNS152600) Harrigan MR (2020) Ischemic stroke due to blunt traumatic cerebrovascular injury. Stroke 51:353–360. (PMID: 10.1161/STROKEAHA.119.026810) Biffl WL, Moore EE, Offner PJ, Brega KE, Franciose RJ, Burch JM (1999) Blunt carotid arterial injuries: implications of a new grading scale. J Trauma Acute Care Surg 47:845. (PMID: 10.1097/00005373-199911000-00004) Miller PR, Fabian TC, Croce MA et al (2002) Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg 236:386–393 discussion 393-385. (PMID: 10.1097/00000658-200209000-00015) Ciapetti M, Circelli A, Zagli G et al (2010) Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria. Scand J Trauma Resusc Emerg Med 18:61. (PMID: 10.1186/1757-7241-18-61) Jacobson LE, Ziemba-Davis M, Herrera AJ (2015) The limitations of using risk factors to screen for blunt cerebrovascular injuries: the harder you look, the more you find. World J Emergency Surg 10:46. (PMID: 10.1186/s13017-015-0040-7) Fleck SK, Langner S, Baldauf J, Kirsch M, Kohlmann T, Schroeder HW (2011) Incidence of blunt craniocervical artery injuries: use of whole-body computed tomography trauma imaging with adapted computed tomography angiography. Neurosurgery 69:615–623 discussion 623-614. (PMID: 10.1227/NEU.0b013e31821a8701) Franz RW, Willette PA, Wood MJ, Wright ML, Hartman JF (2012) A systematic review and meta-analysis of diagnostic screening criteria for blunt cerebrovascular injuries. J Am Coll Surg 214:313–327. (PMID: 10.1016/j.jamcollsurg.2011.11.012) Hundersmarck D, Slooff W-BM, Homans JF et al (2019) Blunt cerebrovascular injury: incidence and long-term follow-up. Eur J Trauma Emergency Surg:1–10. DiCocco JM, Fabian TC, Emmett KP et al (2013) Functional outcomes following blunt cerebrovascular injury. J Trauma Acute Care Surg 74:955–960. (PMID: 10.1097/TA.0b013e318287800f) Biffl WL, Moore EE, Burch JM (2002) Diagnosis and management of thoracic and abdominal vascular injuries. Trauma 4:105–115. (PMID: 10.1191/1460408602ta224oa) Burlew CC, Biffl WL (2011) Imaging for blunt carotid and vertebral artery injuries. Surg Clin North Am 91:217–231. (PMID: 10.1016/j.suc.2010.10.004) Cothren CC, Moore EE, Ray CE Jr et al (2005) Screening for blunt cerebrovascular injuries is cost-effective. Am J Surg 190:849–854. (PMID: 10.1016/j.amjsurg.2005.08.007) Kaye D, Brasel KJ, Neideen T, Weigelt JA (2011) Screening for blunt cerebrovascular injuries is cost-effective. J Trauma Acute Care Surg 70:1051–1057. (PMID: 10.1097/TA.0b013e318211857d) Malhotra A, Wu X, Kalra VB, Schindler J, Matouk CC, Forman HP (2016) Evaluation for blunt cerebrovascular injury: review of the literature and a cost-effectiveness analysis. AJNR Am J Neuroradiol 37:330–335. (PMID: 10.3174/ajnr.A4515) Brommeland T, Helseth E, Aarhus M et al (2018) Best practice guidelines for blunt cerebrovascular injury (BCVI). Scand J Trauma Resusc Emerg Med 26:90. (PMID: 10.1186/s13049-018-0559-1) Roberts D, Chaubey V, Zygun D et al (2012) Diagnostic accuracy of computed tomographic angiography for blunt cerebrovascular injury detection in trauma patients: a systematic review and meta-analysis. Critical Care Med 40:177. Paulus EM, Fabian TC, Savage SA et al (2014) Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it. J Trauma Acute Care Surg 76:279–283 discussion 284-275. (PMID: 10.1097/TA.0000000000000101) Mourad Ouzzani HH, Fedorowicz Z, Elmagarmid A (2016) Rayyan — a web and mobile app for systematic reviews. Systematic Rev 5:210. (PMID: 10.1186/s13643-016-0384-4) Whiting PF, Rutjes AW, Westwood ME et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536. (PMID: 10.7326/0003-4819-155-8-201110180-00009) Bub LD, Hollingworth W, Jarvik JG, Hallam DK (2005) Screening for blunt cerebrovascular injury: evaluating the accuracy of multidetector computed tomographic angiography. J Trauma 59:691–697. (PMID: 16361914) DiCocco JM, Emmett KP, Fabian TC, Zarzaur BL, Williams JS, Croce MA (2011) Blunt cerebrovascular injury screening with 32-channel multidetector computed tomography: more slices still don't cut it. Ann Surg 253:444–450. (PMID: 10.1097/SLA.0b013e31820d946b) Sliker CW, Shanmuganathan K, Mirvis SE (2008) Diagnosis of blunt cerebrovascular injuries with 16-MDCT: accuracy of whole-body MDCT compared with neck MDCT angiography. AJR Am J Roentgenol 190:790–799. (PMID: 10.2214/AJR.07.2378) Clopper CJ, Pearson ES (1934) The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26:404–413. (PMID: 10.1093/biomet/26.4.404) Higgins J, Thompson S, Deeks J, Altman D (2002) Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice. J Health Serv Res Policy 7:51–61. (PMID: 10.1258/1355819021927674) Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM (2008) Systematic reviews of diagnostic test accuracy. Ann Intern Med 149:889–897. (PMID: 10.7326/0003-4819-149-12-200812160-00008) Muller KE, Mok MC (1997) The distribution of cook's d statistic. Commun Stat Theory Methods 26(3). https://doi.org/10.1080/03610927708831932. Rousseeuw PJ, Ruts I, Tukey JW (1999) The Bagplot: A Bivariate Boxplot, The American Statistician, 53(4):382–387. https://doi.org/10.1080/00031305.1999.10474494. Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893. (PMID: 10.1016/j.jclinepi.2005.01.016) Dwamena B (2007) MIDAS: Stata module for meta-analytical integration of diagnostic test accuracy studies. Available via https://ideas.repec.org/c/boc/bocode/s456880.html. Wallace BC, Schmid CH, Lau J, Trikalinos TA (2009) Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data. BMC Med Res Methodol 9:80. (PMID: 10.1186/1471-2288-9-80) Biffl WL, Ray CE Jr, Moore EE, Mestek M, Johnson JL, Burch JM (2002) Noninvasive diagnosis of blunt cerebrovascular injuries: a preliminary report. J Trauma 53:850–856. (PMID: 10.1097/00005373-200211000-00008) Eastman AL, Chason DP, Perez CL, McAnulty AL, Minei JP (2006) Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime? J Trauma 60:925–929 discussion 929. (PMID: 10.1097/01.ta.0000197479.28714.62) Goodwin RB, Beery PR 2nd, Dorbish RJ et al (2009) Computed tomographic angiography versus conventional angiography for the diagnosis of blunt cerebrovascular injury in trauma patients. J Trauma 67:1046–1050. (PMID: 19901666) Malhotra AK, Camacho M, Ivatury RR et al (2007) Computed tomographic angiography for the diagnosis of blunt carotid/vertebral artery injury: a note of caution. Ann Surg 246:632–642 discussion 642-633. (PMID: 10.1097/SLA.0b013e3181568cab) Emmett KP, Fabian TC, DiCocco JM, Zarzaur BL, Croce MA (2011) Improving the screening criteria for blunt cerebrovascular injury: the appropriate role for computed tomography angiography. J Trauma 70:1058–1063 discussion 1063-1055. (PMID: 21610424) Shahan CP, Magnotti LJ, McBeth PB, Weinberg JA, Croce MA, Fabian TC (2016) Early antithrombotic therapy is safe and effective in patients with blunt cerebrovascular injury and solid organ injury or traumatic brain injury. J Trauma Acute Care Surg 81:173–177. (PMID: 10.1097/TA.0000000000001058) Wang AC, Charters MA, Thawani JP, Than KD, Sullivan SE, Graziano GP (2012) Evaluating the use and utility of noninvasive angiography in diagnosing traumatic blunt cerebrovascular injury. J Trauma Acute Care Surg 72:1601–1610. (PMID: 10.1097/TA.0b013e318246ead4) Bromberg WJ, Collier BC, Diebel LN et al (2010) Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. J Trauma and Acute Care Surg 68:471–477. (PMID: 10.1097/TA.0b013e3181cb43da) Grandhi R, Weiner GM, Agarwal N et al (2018) Limitations of multidetector computed tomography angiography for the diagnosis of blunt cerebrovascular injury. J Neurosurg 128:1642–1647. (PMID: 10.3171/2017.2.JNS163264) Liang T, Tso DK, Chiu RY, Nicolaou S (2013) Imaging of blunt vascular neck injuries: a review of screening and imaging modalities. AJR Am J Roentgenol 201:884–892. (PMID: 10.2214/AJR.12.9664) |
فهرسة مساهمة: | Keywords: Angiography, digital subtraction; Cerebrovascular trauma; Computed tomography angiography; Wounds, nonpenetrating |
تواريخ الأحداث: | Date Created: 20211202 Date Completed: 20220316 Latest Revision: 20220816 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC8921112 |
DOI: | 10.1007/s00330-021-08379-7 |
PMID: | 34854931 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1432-1084 |
---|---|
DOI: | 10.1007/s00330-021-08379-7 |