摘要
Abstract
Objective To systematically assess the diagnostic value of computed tomography angiography (CTA) for renal artery stenosis(RAS) by using the meta analysis .Methods The literatures about the CT angiogra‐phy in diagnosing RAS with the digital subtraction angiography(DSA) result as the gold standard were retrieved from the databases of Pubmed ,EBSCO ,Springer ,Ovid ,CNKI and Cochrane library from their establishment to De‐cember 2013 .The literatures were screened according to the inclusion criteria recommended by the Cochrane collabo‐ration network and the included literatures were performed the quality evaluation .Subsequently ,the detailed data were extracted from the included literatures .The Meta Disc 1 .4 software was adopted to perform the heterogeneity test and pooled the sensitivity ,specificity ,positive likelihood ration(PLR) ,negative likelihood ration(NLR) and diag‐nostic odds ration(DOR) .Then ,the summary receiver operating characteristic curve(SROC) was drawn;the area un‐der curve(AUC) was calculated .The sensitivity analysis was carried on .Results Totally 9 articles were included .No threshold value effect among various researches and no obvious heterogeneity were found .The fixed effect model was adopted to conduct the meta analysis ,the pooled indicators like sensitivity ,specificity ,PLR ,NLR and DOR were 0 .975 (95% C I:0 .956-0 .987 ) ,0 .945 (95% C I:0 .923 -0 .962 ) ,12 .656 (95% C I:9 .116 -17 .573 ) ,0 .040 (95% C I:0 .024-0 .067) and 412 .23(95% CI:204 .65 -830 .38) ,respectively .AUC was 0 .987 .The Q index was 0 .951 .The sensitivity analysis demonstrated that the included literatures had good stability .Conclusion CTA is an effective and feasible noninvasive imaging examination method and has higher sensitivity and higher specificity for diagnosing RAS with any degree ,but the mild and severe stenosis diagnosed by CTA should be treated with caution ,especially mild stenosis .关键词
肾动脉狭窄/血管造影术/体层摄影术 ,X线计算机/M eta分析Key words
renal artery stenosis/angiography/tomography/X-ray computed/Meta-analysis
