Peripheral arterial disease: Meta-analysis of the diagnostic performance of MR angiography

被引:153
作者
Nelemans, PJ
Leiner, T
de Vet, HCW
van Engelshoven, JMA
机构
[1] Univ Maastricht, Dept Epidemiol, NL-6229 HA Maastricht, Netherlands
[2] Univ Maastricht, Dept Radiol, NL-6229 HA Maastricht, Netherlands
关键词
arteries; MR; peripheral; stenoses or obstruction; arteriosclerosis; magnetic resonance (MR); comparative studies; technology; receiver operating characteristic (ROC) curve;
D O I
10.1148/radiology.217.1.r00oc11105
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To summarize the overall diagnostic performance of magnetic resonance (MR) angiography in the evaluation of peripheral arteriosclerotic occlusive disease and to identify the most important sources of variation in diagnostic accuracy between studies. MATERIALS AND METHODS: A search strategy in MEDLINE and citation tracking were used to identify relevant English-language articles published since 1991. Each article was critically appraised for examination, patient, and study design characteristics. The accuracy data from different studies were analyzed by constructing summary receiver operating characteristic curves; multiple linear regression was used to examine the variation between study results. RESULTS: Twenty-three studies were included. There was much heterogeneity in the study results, which could not be explained as differences in the threshold for a positive result. About half of the variation was due to the type of MR angiographic examination and the extent of image evaluation. The relative diagnostic odds ratio (DOR) for three-dimensional (3D) gadolinium-enhanced MR angiography compared with two-dimensional (2D) time-of-flight MR angiography was 7.46 (95% CI: :2.48, 22.20). The relative DOR for review of transverse source images or multiplanar; reformations in addition to maximum intensity projections (MIPs) compared with the use of only MIPs for image evaluation was 4.53 (95% CI: 1.46, 13.87). CONCLUSION: The diagnostic accuracy of 3D gadolinium-enhanced MR angiography is superior to that of 2D time-of-flight MR angiography. Also, the review of I transverse source images or use of additional postprocessing techniques, such as multiplanar reformation, results in significantly better diagnostic performance.
引用
收藏
页码:105 / 114
页数:10
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