دورية أكاديمية
أعرض في EDS

Diagnostic accuracy of computed tomography angiography (CTA) for diagnosing blunt cerebrovascular injury in trauma patients: a systematic review and meta-analysis.

التفاصيل البيبلوغرافية
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).)
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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
الوصف
تدمد:1432-1084
DOI:10.1007/s00330-021-08379-7