Document Detail


Intracranial aneurysms in patients with subarachnoid hemorrhage: CT angiography as a primary examination tool for diagnosis--systematic review and meta-analysis.
MedLine Citation:
PMID:  20935079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To calculate the sensitivity and specificity of computed tomographic (CT) angiography in the diagnosis of cerebral aneurysms in patients with acute subarachnoid hemorrhage (SAH) at presentation.
MATERIALS AND METHODS: A systematic search for relevant studies was performed of the PubMed/MEDLINE and EMBASE databases. Two reviewers independently assessed the methodologic quality of each study by using the Quality Assessment of Diagnostic Accuracy Studies tool. The inclusion criteria were met by 50 studies. Heterogeneity was tested, and the presence of publication bias was visually assessed (by using a funnel plot). A meta-analysis of the reported sensitivity and specificity of each study with 95% confidence intervals (CIs) was performed on a per-patient level.
RESULTS: Concerning sensitivity, the selected studies showed moderate heterogeneity. For specificity, low heterogeneity was observed. Moderate-heterogeneity studies that investigated only sensitivity or specificity were excluded from the pooled analyses by using a bivariate random effects model. The majority of the studies (n = 30) used a four-detector row CT scanner. The studies had good methodologic quality. Pooled sensitivity was 98% (95% CI: 97%, 99%), and pooled specificity was 100% (95% CI: 97%, 100%). Potential sources of variability among the studies were variations in the methodologic features (quality score), CT examination procedure (number of rows on the multidetector CT scanner), the standard of reference used, and the prevalence of ruptured intracranial aneurysms. There was evidence for publication bias, which may have led to overestimation of the diagnostic accuracy of CT angiography.
CONCLUSION: Multidetector CT angiography can be used as a primary examination tool in the diagnostic work-up of patients with SAH.
Authors:
Henriëtte E Westerlaan; J M C van Dijk; M J van Dijk; Marijke C Jansen-van der Weide; Jan Cees de Groot; Rob J M Groen; Jan Jakob A Mooij; Matthijs Oudkerk
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2010-10-08
Journal Detail:
Title:  Radiology     Volume:  258     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-02-01     Revised Date:  2011-10-25    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  134-45     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, University Medical Center Groningen, PO Box 30.001, Hanzeplein 1, 9700 RB Groningen, the Netherlands. H.E.Westerlaan@rad.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Aneurysm, Ruptured / radiography,  therapy
Angiography, Digital Subtraction
Cerebral Angiography / methods*
Humans
Intracranial Aneurysm / complications,  radiography*,  therapy
Radiation Dosage
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Comments/Corrections
Comment In:
Radiology. 2011 Jan;258(1):15-7   [PMID:  21183489 ]
Radiology. 2011 Oct;261(1):325-6; author reply 326-7   [PMID:  21931144 ]
Erratum In:
Radiology. 2011 Aug;260(2):612
Note: van Dijk, M J [corrected to van Dijk, J M C]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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