Meta analysis on CT angiography in diagnosing renal artery stenosis

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 angiography 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 December 2013.The literatures were screened according to the inclusion criteria recommended by the Cochrane collaboration network and the included literatures were performed the quality evaluation.Subsequently,the detailed data were extracted from the included literatures.The Meta Disc 1.4software was adopted to perform the heterogeneity test and pooled the sensitivity,specificity,positive likelihood ration(PLR),negative likelihood ration(NLR)and diagnostic odds ration(DOR).Then,the summary receiver operating characteristic curve(SROC)was drawn;the area under curve(AUC)was calculated.The sensitivity analysis was carried on.Results Totally 9articles 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 were0.975(95%CI:0.956-0.987),0.945(95%CI:0.923-0.962),12.656(95%CI:9.116-17.573),0.040(95%CI: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.