Diagnostic performance of single-phase CT angiography in detecting large vessel occlusion in ischemic stroke: A systematic review

被引：8

作者：

Fasen, Bram A. C. M. ^{[1
]}

Heijboer, Roeland J. J. ^{[1
]}

Hulsmans, Frans-Jan H. ^{[1
]}

Kwee, Robert M. ^{[1
]}

机构：

[1] Zuyderland Med Ctr, Dept Radiol, Heerlen Sittard Geleen, Netherlands

来源：

EUROPEAN JOURNAL OF RADIOLOGY | 2021年 / 134卷

关键词：

Stroke; Computed tomography angiography; Sensitivity and specificity; Systematic review; Meta-analysis; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; DIGITAL-SUBTRACTION-ANGIOGRAPHY; CODED DUPLEX SONOGRAPHY; PERFUSION-CT; ACCURACY; SENSITIVITY; STENOSIS; ARTERIES; TRIAGE; IMPACT;

D O I：

10.1016/j.ejrad.2020.109458

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 systematically review the diagnostic performance of single-phase CT angiography (CTA) in detecting intracranial large vessel occlusion (LVO). Method: MEDLINE and Embase were searched for studies investigating the diagnostic performance of single-phase CTA in detecting LVO. Study quality was assessed. Sensitivity and specificity were calculated and meta-analyzed with a bivariate random-effects model. Heterogeneity was assessed with a chi-squared test. Results: Eleven studies were included. High risk of bias with regard to "patient selection", "reference standard", and "flow and timing" was present in 4, 1, and 2 studies, respectively. In 7 studies, it was unclear whether reference tests were interpreted blinded to CTA readings. There was variability in types of vessel segments analyzed, resulting in heterogeneous sensitivity and specificity (P < 0.05). Two studies provided data for the proximal anterior circulation (distal intracranial carotid artery, A1-, A2-, M1- and M2-segments), with pooled sensitivity of 88.4 % (95 % CI: 62.2-97.2 %) and pooled specificity of 98.5 % (95 % CI: 33.2-100 %). One study suggested that multiphase CTA improved agreement between nonexperts and an expert in detecting A1-, A2-, M1-, M2-, and M3-segment occlusions compared to single-phase CTA (kappa = 0.72-0.76 vs. kappa = 0.32-0.45). No other included study reported added value of advanced CTA (CT perfusion, 4D-CTA, or multiphase CTA) compared to single-phase CTA in detecting proximal anterior circulation LVO. Conclusion: There is lack of high-quality studies on the diagnostic performance of single-phase CTA for LVO detection in the proximal anterior circulation. The added value of advanced CTA techniques in detecting proximal anterior circulation LVO is not completely clear yet.

引用

页数：9

共 64 条

[1] Sensitivity of 3D gradient recalled echo susceptibility-weighted imaging technique compared to computed tomography angiography for detection of middle cerebral artery thrombus in acute stroke [J].

Agarwal, Amit ;

Vijay, Kanupriya ;

Thamburaj, Krishnamoorthy ;

Kanekar, Sangam ;

Kalapos, Paul .

NEUROLOGY INTERNATIONAL, 2014, 6 (04) :61-65

[2] Imaging of Patients with Suspected Large-Vessel Occlusion at Primary Stroke Centers: Available Modalities and a Suggested Approach [J].

Almekhlafi, M. A. ;

Kunz, W. G. ;

Menon, B. K. ;

McTaggart, R. A. ;

Jayaraman, M. V. ;

Baxter, B. W. ;

Heck, D. ;

Frei, D. ;

Derdeyn, C. P. ;

Takagi, T. ;

Aamodt, A. H. ;

Fragata, I. M. R. ;

Hill, M. D. ;

Demchuk, A. M. ;

Goyal, M. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2019, 40 (03) :396-400

[3] Thrombus Migration Paradox in Patients With Acute Ischemic Stroke [J].

Alves, Heitor C. ;

Treurniet, Kilian M. ;

Jansen, Ivo G. H. ;

Yoo, Albert J. ;

Dutra, Bruna G. ;

Zhang, Guang ;

Yo, Lonneke ;

van Es, Adriaan C. G. M. ;

Emmer, Bart J. ;

van den Berg, Rene ;

van den Wijngaard, Ido R. ;

Nijeholt, Geert J. Lycklama a ;

Vos, Jan-Albert ;

Roos, Yvo B. W. E. M. ;

Schonewille, Wouter ;

Marquering, Henk A. ;

Majoie, Charles B. L. M. .

STROKE, 2019, 50 (11) :3156-3163

[4] Fast Automatic Detection of Large Vessel Occlusions on CT Angiography [J].

Amukotuwa, Shalini ;

Straka, Matus ;

Dehkharghani, Seena ;

Bammer, Roland .

STROKE, 2019, 50 (12) :3431-3438

[5] Automated Detection of Intracranial Large Vessel Occlusions on Computed Tomography Angiography: A Single Center Experience [J].

Amukotuwa, Shalini A. ;

Straka, Matus ;

Smith, Heather ;

Chandra, Ronil V. ;

Dehkharghani, Seena ;

Fischbein, Nancy J. ;

Bammer, Roland .

STROKE, 2019, 50 (10) :2790-2798

[6] Interrater variability for CT angiography evaluation between neurologists and neuroradiologist in acute stroke patients [J].

Bar, Michal ;

Kral, Jiri ;

Jonszta, Tomas ;

Marcian, Vaclav ;

Kuliha, Martin ;

Mikulik, Robert .

BRITISH JOURNAL OF RADIOLOGY, 2017, 90 (1071)

[7] Determination of the Middle Cerebral Artery Occlusion Length in Acute Stroke: Contribution of 4D CT Angiography and Importance for Thrombolytic Efficacy Prediction [J].

Baxa, J. ;

Rohan, V. ;

Tupy, R. ;

Cerna, L. ;

Flohr, T. ;

Polivka, J. ;

Ferda, J. .

CLINICAL NEURORADIOLOGY, 2015, 25 (03) :257-265

[8] Brain CT perfusion improves intracranial vessel occlusion detection on CT angiography [J].

Becks, Marinus J. ;

Manniesing, Rashindra ;

Vister, Jeroen ;

Pegge, Sjoert A. H. ;

Steens, Stefan C. A. ;

van Dijk, Ewoud J. ;

Prokop, Mathias ;

Meijer, Frederick J. A. .

JOURNAL OF NEURORADIOLOGY, 2019, 46 (02) :124-129

[9] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[10] Improved Detection of Anterior Circulation Occlusions: The "Delayed Vessel Sign" on Multiphase CT Angiography [J].

Byrne, D. ;

Sugrue, G. ;

Stanley, E. ;

Walsh, J. P. ;

Murphy, S. ;

Kavanagh, E. C. ;

MacMahon, P. J. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2017, 38 (10) :1911-1916

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