| 易梅 赵一平 李松柏 刘白鹭 郭冬梅.CT灌注与CT 血管成像对蛛网膜下腔出血后脑血管痉挛诊断价值的Meta分析[J].,2015,15(29):5670-5673 |
| CT灌注与CT 血管成像对蛛网膜下腔出血后脑血管痉挛诊断价值的Meta分析 |
| Meta Analysis on Value of CT Perfusion and CT Angiography Diagnosis ofVasospasmafter Onset of Subarachnoid Hemorrhage |
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| DOI： |
| 中文关键词: 体层摄影术 X 线计算机 灌注成像 血管造影 蛛网膜下腔出血 脑血管痉挛 Meta 分析 |
| 英文关键词: Computed tomography X-ray computer Perfusion Angiography Subarachnoid hemorrhage Cerebral vasospasm Meta analysis |
| 基金项目:国家自然科学基金面上项目（81071151） |
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| 中文摘要: |
| 目的：采用Meta 分析法比较CT 脑血流灌注（computer tomography perfusion，CTP）与CT 血管造影（computer tomography
angiography，CTA）在蛛网膜下腔出血(subarachnoid hemorrhage，SAH)后脑血管痉挛（cerebral vasospasm，CVS）的诊断价值。方法：
以SinoMed、中国期刊网、维普数据库等为国内文献的主要来源；Cochrane 图书馆、Medline 数据库及Ovid 数据库、Elsevier 和
Springer数据库等作为国外文献的主要来源。发表年限为1999 年至2014 年。按照Cochran 协作网推荐的诊断试验纳入标准选取
文献，并提取纳入研究的诊断信息。统计分析采用RevMan 5.0 软件，并同时考察纳入文献间的异质性，再根据异质性结果选择相
应的效应模型。对所纳入的研究予以加权定量合并，得出合并效应量，计算其95%可信区间，并对合并效应量进行假设检验。结
果：按照纳入标准共获取文献6 篇，其中有关CTP 的3 篇（多层螺旋CT），CTA 为4 篇，均有金标准DSA比较；前瞻性研究2 篇，
回顾性研究4 篇。各组研究均不存在异质性，按照固定效应模型对纳入文献行汇总分析。结果显示，对于蛛网膜出血后脑血管痉
挛、CTP 诊断的合并效应量估计值为1.59，95%可信区间为0.94-2.69；CTA合并效应量估计值为1.45，95%可信区间为1.18-1.77。
结论：对于蛛网膜下腔出血后脑血管痉挛，CTP 诊断的准确性高于CTA诊断。 |
| 英文摘要: |
| Objective:To assess and compare the overall diagnostic value of CT perfusion (CTP) and CT angiography (CTA) in
patients with cerebral vasospasm (CVS) after onset of subarachnoid hemorrhage (SAH).Methods:Articles in Cochrane library, Medline,
Ovid, Elsevier and Springer databases published from 1999 to 2014 were selected to be the relevant English articles; Articles in Chinese
Periodical Web, SinoMed, and VIP database were checked for Chinese articles. The criteria for inclusion were established based on validity
criteria for diagnostic research published by Cochrane Method Group on Screening and Diagnostic Test. Subsequently, the characteristics
of the included articles were appraised and extracted. Statistical analysis was performed employing RevMan 5.0. Heterogeneity
and combined test of the included articles finished, which were used to calculate corresponding 95% confidence interval.Results:Six of
the 192 retrieved articles were included. Among them, there were three articles refered to CTP and another four articles refered to CTA.
All of the involved articles were compared with digital subtraction angiography (DSA). Two were prospective study and four were retrospective.
There was no heterogeneity in each groups, and a fixed effect regression was developed to analyze the involved articles. The
combined test for CTP to vasospasmafter SAH was 1.59, 95%confidence interval (CI) was 0.94-2.69; and CTA to vasospasmafter SAH
was 1.45. 95% CI was 1.18-1.77.Conclusion:With respect to diagnostic accuracy and conclusive result, CTP is more accurate than
CTA in diagnosing vasospasmafter SAH. |
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