Reliability of Echocardiography Measurement of Patent Ductus Arteriosus Minimum Diameter: A Meta-analysis

Objective: To systematically evaluate the reliability of transthoracic echocardiographic (TTE) measurements of the narrowest diameter in patients with patent ductus arteriosus (PDA) in comparison to angiographic measurements. Methods: We searched articles published between January 1990 to August 2015 that compared diameters of PDA both measured by TTE and angiography in PubMed, Cochrane Library, Wanfang Data database, and CNKI. Two researchers screened the literature, extracted data and assess the quality independently. Weighted mean difference (WMD) and 95% confidence intervals (95% CI) were calculated, heterogeneity was evaluated, and publication bias was estimated. The correlation coefficients of the narrowest PDA diameter measured by echocardiography and angiography were merged by RevMan 5.2 and Stata 12.0 software. Results: 11 articles involving 870 patients are included. Meta-analysis demonstrated that measurement values of the minimum inner diameter by TTE were greater compared to angiography measurements (WMD = 0.86,95% CI: 0.71 ~ 1.02, P <0.001). Echocardiographic and angiographic measurements correlated closely with each other (R = 0.75,95% CI: 0.52 ~ 0.97). There was no evidence of publication bias. Conclusions Measurement of the minimum inner diameter of PDA by TTE has value for both the selection of therapeutic strategy and the PDA occluder model. Nevertheless, echocardiography overestimates minimum diameter in comparison to angiography.