| 摘要: |
| 目的 系统评价经颅多普勒超声(TCD)对≥50%的大脑中动脉(MCA)狭窄的诊断价值,并评估血流速度的最佳诊断值。方法 由两名研究者独立的进行文献筛选及相关数据的提取。文献的检索时间限定为2000年1月1日到2017年9月30日。采用电子检索的方式对以下数据库进行了检索：PubMed、Web of Science、Cochrane Library、CNKI、万方、维普。采用QUADAS方法对纳入文献的质量进行评价,采用Meta-disc 1.4软件进行统计学分析。结果 最终共有16项研究纳入到本次分析中。100cm/s和140cm/s是TCD诊断≥50%的MCA狭窄的平均血流速度(MFV)和峰值血流速度(PSV)的最佳诊断值。以DSA、磁共振血管造影(MRA)或CT血管造影(CTA)为参照标准时,MFV≥100cm/s和PSV≥140cm/s的敏感性为0.71和0.75、特异性为0.94和0.91、阳性似然比为5.54和10.00、阴性似然比为0.25和0.27。以数字减影血管造影(DSA)为参照标准时,MFV≥100cm/s和PSV≥140cm/s的敏感性为0.77和0.79、特异性为0.94和0.96、阳性似然比为12.68和19.85、阴性似然比为0.23和0.22。结论 TCD对≥50%的MCA狭窄具有较高的诊断价值,其MFV和PSV的最佳诊断值为100cm/s和140cm/s。TCD可以作为≥50%MCA狭窄的筛查手段。 |
| 关键词: 经颅多普勒超声 大脑中动脉 狭窄 诊断 Meta分析 |
| DOI： |
| 投稿时间：2017-11-02修订日期：2017-11-02 |
| 基金项目: |
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| The diagnostic value of transcranial doppler for middle cerebral artery stenosis: a meta-analysis |
| LIU Juan,LIU Guangwei |
| () |
| Abstract: |
| Objective To systematically review the diagnostic value of transcranial doppler for ≥50% middle cerebral artery stenosis, and evaluate the best cutoff value of blood flow velocity. Methods All data were independently searched and extracted in duplicate by two investigators. By searching PubMed, Web of science, Cochrane liberary, CNKI, Wanfang and VIP database from 1 January 2000 to 30 September 2017, all of the eligible articles which conformed to the inclusion and exclusion criteria were harvested. The quality of each included literature was evaluated by QUADAS tools. Statistical analysis was conducted by the Meta-Disc software. Results A total of 16 articles were analyzed in this meta-analysis. The best cutoff values of the mean flow velocity (MFV) and the peak systolic velocity (PSV) were ≥100cm/s and ≥140cm/s. Using digital subtraction angiography (DSA) as gold standard, the pooled sensitivity, specificity, positive likelihood radio and negative likelihood ratio were 0.77, 0.94, 12.68 and 0.23 for MFV≥100cm/s, and 0.79, 0.96, 19.85 and 0.22 for PSV≥140cm/s. Using DSA, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) as gold standard, the pooled sensitivity, specificity, positive likelihood radio and negative likelihood ratio were 0.71, 0.94, 5.54 and 0.25 for MFV≥100cm/s, and 0.75, 0.91, 10.00 and 0.27 for PSV≥140cm/s. Conlusions When MFV≥100cm/s and PSV≥140cm/s, TCD shows high value in the diagnosis of ≥50% MCA stenosis, and it can be used as an effective screening test in clinical practice. |
| Key words: Transcranial doppler Middle cerebral artery Stenosis Diagnosis Meta-analysis |
