■通过Meta分析评价和比较经颅多普勒超声造影(c-TCD)和经胸超声心动图(c-TTE)对卵圆孔未闭(PFO)右向左分流(RLS)的诊断价值。
■包含在Cochrane图书馆中的文献,PubMed,使用“对比增强经颅多普勒(c-TCD)”进行Embase搜索,经胸超声心动图(c-TTE),卵圆孔未闭(PFO),从右到左分流(RLS)“作为关键字,从开始到2024年4月30日。采用诊断准确性研究质量评估工具(QUADAS-2)对纳入文献进行质量评价。组合的灵敏度,特异性,正似然比(PLR),负似然比(NLR),和诊断比值比(DOR)进行汇总,并进行全面的ROC曲线分析。采用统计软件StataSE12.0和Meta-Disc1.4进行数据分析。
■共检索到8536篇,符合所有纳入标准的9篇文章纳入本荟萃分析.荟萃分析结果表明,联合敏感性,特异性,PLR,NLR,DOR,c-TCD诊断PFO-RLS的SROC曲线下面积为0.91(95%CI,0.88-0.93),0.87(95%CI:0.84-0.91),6.0(95%CI,2.78-12.96),0.10(95%CI,0.06-0.18),91.61(95%CI,26.55-316.10),和0.9681;c-TTE的相应值为0.86(95%CI,0.84-0.89),0.88(95%CI,0.84-0.91),5.21(95%CI,2.55-10.63),0.16(95%CI,0.09-0.31),71.43(95%CI,22.85-223.23),和0.9532。ROC曲线显示c-TCD对PFO的诊断价值略高于c-TTE,但差异无统计学意义(Z=0.622,p>0.05)。Deek漏斗图没有明显的发表偏倚。
■c-TCD和c-TTE对PFO-RLS均具有很高的诊断价值。然而,与c-TTE相比,c-TCD在诊断PFO-RLS方面具有较高的灵敏度和较低的特异性。系统审查注册:标识符[CRD42024544169]。
UNASSIGNED: To evaluate and compare the diagnostic value of contrast-enhanced transcranial Doppler (c-TCD) and contrast-enhanced transthoracic echocardiography (c-TTE) for right to left shunt (RLS) in patent foramen ovale (PFO) by meta-analysis.
UNASSIGNED: The literature included in the Cochrane Library, PubMed, and Embase were searched by using \"contrast-enhanced transcranial Doppler (c-TCD), contrast-enhanced transthoracic echocardiography (c-TTE), patent foramen ovale (PFO), and right to left shunt (RLS)\" as the keywords from inception through April 30, 2024. The diagnostic accuracy research quality assessment tool (QUADAS-2) was used to evaluate the quality of the included literature. The combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and Diagnostic odds ratio (DOR) were pooled, and a comprehensive ROC curve analysis was performed. Statistical software StataSE 12.0 and Meta-Disc 1.4 were used for data analysis.
UNASSIGNED: A total of 8,536 articles were retrieved, and 9 articles that met all inclusion criteria were included in this meta-analysis. The meta-analysis results show that the combined sensitivity, specificity, PLR, NLR, DOR, and area under the SROC curve of c-TCD for the diagnose of PFO-RLS were 0.91 (95% CI, 0.88-0.93), 0.87 (95% CI: 0.84-0.91), 6.0 (95% CI, 2.78-12.96), 0.10 (95% CI, 0.06-0.18), 91.61 (95% CI, 26.55-316.10), and 0.9681, respectively; the corresponding values of c-TTE were 0.86 (95% CI, 0.84-0.89), 0.88 (95% CI, 0.84-0.91), 5.21 (95% CI, 2.55-10.63), 0.16 (95% CI, 0.09-0.31), 71.43 (95% CI, 22.85-223.23), and 0.9532. The ROC curve shows that c-TCD has slightly higher diagnostic value for PFO than c-TTE, but there is no significant statistical difference (Z = 0.622, p > 0.05). Deek funnel pattern showed no significant publication bias.
UNASSIGNED: Both c-TCD and c-TTE have high diagnostic values for PFO-RLS. However, c-TCD has slightly higher sensitivity and lower specificity in diagnosing PFO-RLS compared to c-TTE.Systematic
review registration: identifier [CRD42024544169].