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首页> 外文期刊>Radiology >Coronary arteries: diagnostic performance of 16- versus 64-section spiral CT compared with invasive coronary angiography--meta-analysis.
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Coronary arteries: diagnostic performance of 16- versus 64-section spiral CT compared with invasive coronary angiography--meta-analysis.

机译：冠状动脉：与有创冠状动脉造影相比，16层螺旋CT和64层螺旋CT的诊断性能-元分析。

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PURPOSE: To perform a meta-analysis to compare the diagnostic performance of 16- versus 64-section computed tomography (CT) for the diagnosis of coronary artery disease (CAD). MATERIALS AND METHODS: The MEDLINE database was searched for relevant original articles. Criteria for inclusion of articles were (a) use of multisection spiral CT as a diagnostic test for obstructive CAD, (b) use of the newer generation of multisection spiral CT (16 or 64 section) scanners, and (c) use of coronary angiography as the reference standard for diagnosing obstructive CAD (>50% diameter stenosis was selected as the cutoff criterion for diagnosis of CAD). After data extraction, the analysis was performed according to a random-effects model. Between-study statistical heterogeneity also was assessed by using Cochran Q chi(2) tests. RESULTS: Of 328 identified relevant articles, 37 fulfilled all inclusion criteria, with data available for a patient-based analysis in 28. The patient-based analysis included pooled data from 16studies, corresponding to 1292 patients who underwent 16-section spiral CT, and from 12 studies, corresponding to 695 patients who underwent 64-section spiral CT. Respectively, the results for 16-section CT versus 64-section CT were 95% (95% confidence interval [CI]: 93%, 96%) versus 97% (95% CI: 95%, 98%) for sensitivity (P = .03), 69% (95% CI: 66%, 73%) versus 90% (95% CI: 86%, 93%) for specificity (P < .001), 79% (95% CI: 76%, 82%) versus 93% (95% CI: 91%, 96%) for positive predictive value (PPV) (P < .001), 92% (95% CI: 88%, 94%) versus 96% (95% CI: 92%, 98%) for negative predictive value (P < .001), and 72.05 (95% CI: 31.35, 165.56) versus 181.82 (95% CI: 88.70, 372.71) for diagnostic odds ratio (P = .1). CONCLUSION: Sixty-four-section spiral CT has significantly higher specificity and PPV on a per-patient basis compared with 16-section CT for the detection of greater than 50% stenosis of coronary arteries. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2453061899/DC1.
机译：目的：进行荟萃分析，比较16断层扫描和64断层计算机断层扫描（CT）在诊断冠状动脉疾病（CAD）方面的诊断性能。材料与方法：在MEDLINE数据库中搜索相关的原始文章。纳入标准包括：（a）使用多节螺旋CT作为阻塞性CAD的诊断测试;（b）使用新一代的多节螺旋CT（16或64节）扫描仪;以及（c）使用冠状动脉造影作为诊断阻塞性CAD的参考标准（直径狭窄≥50％被选为诊断CAD的临界标准）。数据提取后，根据随机效应模型进行分析。研究之间的统计异质性也通过使用Cochran Q ch​​i（2）测试进行了评估。结果：在328篇已鉴定的相关文章中，有37篇符合所有纳入标准，其中28篇数据可用于基于患者的分析。基于患者的分析包括来自16个研究的汇总数据，对应于接受了16层螺旋CT扫描的1292例患者，以及来自12项研究的695例患者接受了64层螺旋CT扫描。 16层CT与64层CT的敏感性（P分别为95％（95％置信区间[CI]：93％，96％）与97％（95％CI：95％，98％） = .03），特异性（P <.001）的90％（95％CI：86％，93％）为69％（95％CI：66％，73％），79％（95％CI：76％） ，82％）与93％（95％CI：91％，96％）的阳性预测值（PPV）（P <.001），92％（95％CI：88％，94％）与96％（95）阴性预测值（P <.001）的CI分别为92％，98％和72.05（95％CI：31.35，165.56）（182.52（95％CI：88.70，372.71））（90） 1）。结论：与16层CT相比，六十四层螺旋CT在每位患者上具有更高的特异性和PPV，可检测出50％以上的冠状动脉狭窄。补充材料：http：//radiology.rsnajnls.org/cgi/content/full/2453061899/DC1。

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