CT angiography in the diagnosis of carotid artery stenosis:a Meta analysis

Objective To assess the overall diagnostic value of multi-slice spiral computed tomography angiography(MSCTA)in patients with suspected carotid artery stenosis with the digital subtraction angiography as the gold standard.Methods A search in Cochrane Library,PubMed,OVID,and CNKI was performed to identify relevant English and Chinese language articles.Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on screening and diagnostic tests.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta-DiSc 1.4.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity.Summary Receiver Operating Characteristic(SROC)curve was performed and the area under the curve(AUC)was calculated.Results 7 of 398 retrieved articles were included.The pooled weighted sensitivity and specificity with 95% confidence interval(95% CI)for 0-49% were 0.87(0.82-0.91)and 0.97(0.94-0.99),respectively.The pooled weighted sensitivity and specificity with 95% CI for 50%-69% were 0.77(0.67-0.86)and 0.95(0.92-0.97),respectively.The pooled weighted sensitivity and specificity with 95% CI for 70%-99% were 0.92(0.86-0.96)and 0.93(0.89-0.95),respectively.The AUC of SROC for the three groups were 98.36%,90.01%,98.47%,respectively.Conclusions MSCTA has a highly accurate sensitivity and specificity with a strong ROC curve making it an alternative non-invasive method in the diagnosis of carotid artery stenosis and is worthy of promotion.