Dual-source computed tomography angiography for diagnosis and assessment of coronary artery disease: Systematic review and meta-analysis

作者：Salavati Ali^*; Radmanesh Farid; Heidari Kazem; Dwamena Ben A; Kelly Aine M; Cronin Paul

来源：Journal of Cardiovascular Computed Tomography, 2012, 6(2): 78-90.

DOI：10.1016/j.jcct.2011.10.018

• Cardiac-gated imaging techniques
• Computed tomography
• Coronary angiography
• Coronary artery disease
• Meta-analysis

BACKGROUND: Development of an accurate test for noninvasive assessment of coronary arteries has been highly desirable. %26lt;br%26gt;OBJECTIVES: We performed a systematic review of diagnostic accuracy of the dual-source computed tomography (DSCT) in the diagnosis of coronary artery disease (CAD). %26lt;br%26gt;METHODS: Eight medical databases were searched for articles published from January 2005 through March 2011. Studies compared DSCT coronary angiography (DSCT-CA) and invasive coronary angiography, as the reference standard, in consecutive patients with suspected or known CAD, and relevant data were extracted by 2 independent reviewers. Summary diagnostic accuracies were calculated, and the effect of covariates on the diagnostic performance was evaluated by meta-regression. %26lt;br%26gt;RESULTS: Twenty-five studies were included. In per-patient analysis (n = 2303), pooled sensitivity was 99% [95% confidence interval (Cl), 97%-99%] with specificity of 89% (95% CI, 84%-92%). The summary positive (+LR) and negative (-LR) likelihood ratios were 8.6 (95% CI, 6.4-11.6) and 0.02 (95% CI, 0.01-0.03), respectively. In per-segment analysis (n = 32,615), pooled sensitivity was 94% (95% CI, 92%-96%) with specificity of 97% (95% CI, 96%-98%). Summary +LR and -LR were 30.2 (95% CI, 22.1-43.5) and 0.06 (95% CI, 0.04-0.08), respectively. %26lt;br%26gt;CONCLUSIONS: DSCT-CA seems to be robust to elevate heart rates while maintaining a high level of diagnostic performance.

• 出版日期2012-4