Vincent Raymaekers , Ana Rodríguez-Hernández , Sjoert A.H. Pegge , Tomas Menovsky , Frederick J.A. Meijer , Jeroen H.D. Boogaarts
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引用次数: 0
Abstract
Background
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 4D magnetic resonance angiography (4D-MRA) can be used to increase the diagnostic accuracy of spinal magnetic resonance imaging 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% confidence interval [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 were correct in 91% (95% CI: 86%–94%) and 76% (95% CI: 71%–80%), respectively.
Conclusions
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.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
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