Diagnostic Accuracy of 4D-MRA for the Detection and Localization of Spinal Dural Arteriovenous Fistulas: a systematic review and meta-analysis.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-29 DOI:10.1016/j.wneu.2024.10.087

Vincent Raymaekers, Ana Rodríguez-Hernández, Sjoert A H Pegge, Tomas Menovsky, Frederick J A Meijer, Jeroen Hd Boogaarts

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Abstract

Background and purpose: The gold standard for the diagnosis and detailed evaluation of spinal dural arteriovenous fistula (SDAVF) is a digital subtraction angiography (DSA). However, this procedure is time-consuming and effortful. A time-resolved contrast enhanced MR angiography sequence (4D-MRA) can be used to increase the diagnostic accuracy of spinal MRI for the detection and localization of a SDAVF. The goal of this study is to assess the diagnostic accuracy of 4D-MRA for the detection and localization of a SDAVF in comparison to DSA, based on a systematic review of the literature.

Methods: We performed a systematic review and meta-analysis on the diagnostic accuracy of 4D-MRA compared to DSA. Literature was reviewed from the PubMed, Cochrane and EMBASE databases.

Results: In comparison with DSA, the pooled sensitivity of MRA was 98,2% (95% CI 91,5-99,6%), with a pooled specificity of 88,2% (95%CI 57,5-97,6%) for the diagnosis of SDAVFs. The side and level of the SDAVFs was correct in 91% (95% CI: 86-94%) and 76% (95% CI: 71-80%), respectively.

Conclusion: Current literature indicates that 4D-MRA has a high sensitivity and specificity for the detection and localization of a SDAVF. It can serve to guide DSA to shorten the procedural time, reduce the risk of complications and decrease patient discomfort.

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4D-MRA 对脊髓硬脑膜动静脉瘘的检测和定位的诊断准确性：系统回顾和荟萃分析。

背景和目的：数字减影血管造影术（DSA）是诊断和详细评估脊髓硬膜动静脉瘘（SDAVF）的金标准。然而，这种方法费时费力。时间分辨对比增强磁共振血管造影序列（4D-MRA）可用于提高脊柱磁共振成像在检测和定位 SDAVF 方面的诊断准确性。本研究的目的是在对文献进行系统回顾的基础上，评估 4D-MRA 与 DSA 相比在 SDAVF 检测和定位方面的诊断准确性：我们对 4D-MRA 与 DSA 相比的诊断准确性进行了系统回顾和荟萃分析。我们从 PubMed、Cochrane 和 EMBASE 数据库中查阅了相关文献：结果：与 DSA 相比，MRA 诊断 SDAVF 的集合敏感性为 98.2%（95%CI 91.5-99.6%），集合特异性为 88.2%（95%CI 57.5-97.6%）。SDAVFs的侧面和水平的正确率分别为91%（95%CI：86-94%）和76%（95%CI：71-80%）：目前的文献表明，4D-MRA 对 SDAVF 的检测和定位具有很高的灵敏度和特异性。结论：目前的文献表明，4D-MRA 对 SDAVF 的检测和定位具有较高的灵敏度和特异性，可用于指导 DSA 以缩短手术时间、降低并发症风险和减轻患者不适。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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