title: Meta-analysis of diagnostic significance of sixty-four-row multi-section computed tomography angiography and three-dimensional digital subtraction angiography in patients with cerebral artery aneurysm.
abstract: OBJECTIVE
  Imaging methods are essential in evaluating cerebral artery aneurysms and they have evolved with recent technical advances. Sixty-four-row multi-section computed tomography (64-MSCT) angiography and three-dimensional digital subtraction angiography (3D-DSA) are two of the most popular methods. We sought to systematically explore and find out which one would be better in imaging cerebral artery aneurysm, and try to investigate the potential use and value of 64-MSCT angiography and 3D-DSA in cerebral artery aneurysm.
  
  
  METHODS
  Followed by a predefined comprehensive literature search, we carefully searched both English and Chinese electronic databases for potentially relevant studies following our meta-analysis. Two reviewers independently assessed the methodological quality of the included eligible trials based on quality assessment of studies of diagnostic accuracy studies (QUADAS). Pooled summary statistics for sensitivity, specificity, positive and negative likelihood ratios (positive LR and negative LR), and diagnostic odds ratio (ORs) with their 95% confidence intervals (CIs) were utilized.
  
  
  RESULTS
  Final meta-analysis of 923 cerebral artery aneurysm cases were incorporated from eight cohort studies and selected for statistical analysis. Pooled sensitivity and specificity of 64-MSCT angiography in the diagnosis of cerebral artery aneurysm were 0.97 (95% CI, 0.96-0.98) and 0.91 (0.88-0.94), respectively. The pooled positive LR was 7.68 (95% CI, 3.34-17.67); and the pooled negative LR was 0.04 (95% CI, 0.03-0.05). The pooled diagnostic OR was 263.69 (95% CI, 121.19-573.77). The area under the SROC curve was 0.9934 (standard error [SE] = 0.0031). No significant evidence of publication bias was detected (P > 0.05).
  
  
  CONCLUSIONS
  The main finding of our meta-analysis revealed that 64-MSCT angiography relative to the 3D-DSA may have a high diagnostic accuracy for the cerebral artery aneurysm. Thus, 64-MSCT angiography may be an effective tool for the early detection of cerebral artery aneurysm.
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China; Department of Neurosurgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China.
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: He
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China.
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, PR China.
authors.forename: Dong-Xiang
authors.initials: DX
authors.lastname: Qian
authors.affiliation: Department of Neurosurgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, PR China.
authors.forename: Jian-Quan
authors.initials: JQ
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, PR China.
authors.forename: De-Lin
authors.initials: DL
authors.lastname: Bu
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China. Electronic address: duanchuanzhi715@126.com.
authors.forename: Chuan-Zhi
authors.initials: CZ
authors.lastname: Duan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D002533:Cerebral Angiography / Q000379:methods; D016001:Confidence Intervals; D021621:Imaging, Three-Dimensional / Q000379:methods; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging; D016017:Odds Ratio; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Cerebral artery aneurysm; Diagnostic; Meta-analysis; Odds ratio; Sixty-four-row multi-section computed tomography angiography; Three-dimensional digital subtraction angiography