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A systematic review and meta-analysis on transcranial Doppler in diagnosing ischemic cerebrovascular disease
Jieqing Zhou1, Yu Shan2, Pan Hu3
1Pediatrics Department, The First Hospital of China Medical University, Shenyang, China.
Insights
Transcranial Doppler (TCD) ultrasound shows high accuracy in diagnosing ischemic cerebrovascular disease (ICVD). This cost-effective method offers a promising alternative for early detection and improved patient outcomes.
Area of Science:
- Neurology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Ischemic cerebrovascular disease (ICVD) incidence is rising, causing significant disability and mortality.
- Digital subtraction angiography (DSA) is the current standard but is invasive and costly.
- Transcranial Doppler (TCD) ultrasound presents an accurate, simple, and low-cost diagnostic option.
Purpose of the Study:
- To evaluate the diagnostic performance of Transcranial Doppler (TCD) ultrasound for Ischemic Cerebrovascular Disease (ICVD).
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Web of Science, Embase, Cochrane Library) from 2000 to 2020.
- Quality assessment, meta-analysis using RevMan 5.3, and publication bias analysis using STATA 12.0 were performed.
- Summary Receiver Operating Characteristic (SROC) curves were generated to assess overall diagnostic accuracy.
Main Results:
- Eleven studies were included in the meta-analysis.
- The combined sensitivity of TCD for ICVD diagnosis was 0.93 (95% CI: 0.75-1.00).
- The combined specificity of TCD for ICVD diagnosis was 0.95 (95% CI: 0.78-1.00), with an Area Under the Curve (AUC) of 0.887.
Conclusions:
- Transcranial Doppler (TCD) ultrasound demonstrates excellent diagnostic capabilities for ICVD.
- TCD is recommended for clinical application to facilitate early diagnosis and improve patient prognosis.
- This non-invasive technique offers a valuable tool for managing ICVD.
Background:
The incidence of ischemic cerebrovascular disease (ICVD) has been increasing, leading to disability and deaths among middle-aged and elderly people. Digital subtraction angiography (DSA) is the gold standard for diagnosing ICVD, but it is invasive, expensive, and complex to operate. Transcranial Doppler (TCD) ultrasound is characterized by high accuracy, simplicity, and low cost, and thus became the focus of this study.
Methods:
The databases of PubMed, Web of Science, Embase, and The Cochrane Library were searched from January 2000 to September 2020, for literature involving the use of TCD to diagnose ICVD. The software RevMan 5.3 was used for quality assessment, and forest plots and summary receiver operating characteristic (SROC) curves were drawn. The software STATA12.0 was adopted for publication bias analysis.
Results:
A total of 11 references were included, and the combined sensitivity, specificity, and 95% confidence interval (CI) of TCD were 0.93 (0.75 to 1.00) and 0.95 (0.78 to 1.00), respectively. The area under the curve (AUC) of SROC was 0.887.
Discussion:
Superb capabilities in diagnosing ICVD have been demonstrated by TCD, and it should therefore be applied in the clinic. The results are important to realize early diagnosis of ICVD and improve the prognosis of patients.
