Meta-analysis of computed tomography angiography versus magnetic resonance angiography for intracranial aneurysm

Abstract

Background: Whether the diagnosis value of computed tomography angiography (CTA) for intracranial aneurysm is in accordance with magnetic resonance angiography (MRA) remains inconclusive. This meta-analysis aims to synthesize relevant studies to compare the diagnostic efficacies of the 2 methods.

Methods: Potentially relevant studies were selected through PubMed, Embase, Wanfang, Chongqing VIP, and China National Knowledge Infrastructure databases by using the core terms "computer tomography angiography" (CTA) and "magnetic resonance angiography" (MRA) and "intracranial aneurysm*" in the titles, abstracts, and keywords of the articles. Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2) was utilized to evaluate the quality. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were count. Summary receiver operating characteristic curves (SROC) and area under the curve (AUC) were used to summarize the overall diagnostic performance. Statistical analyses were performed by Stata version 12.0 and MetaDisc 1.4 software.

Results: Ten articles were identified in this current paper. For CTA, the pooled estimates of diagnostic parameters for intracranial aneurysm were as follows: sensitivity, 0.84 (95%CI = 0.81-0.86); specificity, 0.85 (95%CI = 0.79-0.89); PLR, 4.09 (95%CI = 2.45-6.81); NLR, 0.18 (95%CI = 0.11-0.28); DOR, 23.74 (95%CI = 10.49-53.74); AUC, 0.90, respectively. For MRA, the pooled estimates of diagnostic parameters for intracranial aneurysm were as follows: sensitivity, 0.80 (95%CI = 0.77-0.83); specificity, 0.87 (95%CI = 0.82-0.91); PLR, 3.61 (95%CI = 1.72-7.55); NLR; 0.27 (95%CI = 0.21-0.35); DOR, 16.77 (95%CI = 7.38-38.11); AUC, 0.87, respectively. No significant difference was found the AUC value between CTA and MRA for intracranial aneurysm (Z = 0.828, P > .05).

Conclusion: This comprehensive meta-analysis demonstrated that the diagnosis value of CTA was in accordance with MRA for intracranial aneurysm. However, considering the limitation of sample size, the results should be treated with caution.

Figure 1

Flowchart of study selection procedure.

Figure 2

The pooled diagnostic indices for the diagnosis of intracranial aneurysm through CTA (A) sensitivity (B) specificity (C) positive LR (D) Negative LR. CTA = computed tomography angiography, LR = likelihood ratio.

Figure 3

Diagnostic odds ratio (DOR) (A) CTA (B) MRA. CTA = computed tomography angiography, DOR = diagnostic odds ratio, MRA = magnetic resonance angiography.

Figure 4

Summary receiver characteristics (SROC) (A) CTA (B) MRA. CTA = computed tomography angiography, MRA = magnetic resonance angiography, SROC = summary receiver operating characteristic curves.

Figure 5

Deeks’ funnel plot (A) CTA (B) MRA. CTA = computed tomography angiography, MRA = magnetic resonance angiography.

Figure 6

The pooled diagnostic indices for the diagnosis of intracranial aneurysm through MRA (A) sensitivity (B) specificity (C) positive LR (D) negative LR. LR = likelihood ratio, MRA = magnetic resonance angiography.