在外周动脉疾病中双重超声波的准确性:系统性审查和元分析
Silfayner Victor Mathias Dias1, Ronald Luiz Gomes Flumignan1, Nelson Carvas1
1Universidade Federal de São Paulo - UNIFESP, Escola Paulista de Medicina - EPM, São Paulo, SP, Brasil.
Jornal vascular brasileiro
|February 21, 2025
概括
双重超声波 (DUS) 是对外周动脉疾病 (PAD) 的推诊断工具. 这次审查发现,DUS对于症状性PAD一般是准确的,在股骨片段表现最好.
科学领域:
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
- 医学诊断 医学诊断 医学诊断
背景情况:
- 下肢外周动脉疾病 (PAD) 是一个常见的疾病.
- 目前的指导方针主张双重超声 (DUS) 与光谱分析用于PAD诊断.
研究的目的:
- 在有症状的PAD患者中系统地审查和元分析DUS的诊断准确性.
- 评估不同下肢动脉段的DUS性能.
主要方法:
- 对比DUS与动脉谱的研究的系统综述和元分析.
- 对诊断准确度指标的分析,包括灵敏度,特异性和诊断概率比率 (DOR).
- 分析的动脉段:大动脉-常见的股骨,股骨,膝盖以下,以及整个下肢.
主要成果:
- 分析了15项涉及9067条动脉的研究.
- 对症状性PAD的整体DUS灵敏度为0.86,特异性为0.95.
- 最高的精度是在股骨片段 (灵敏度0.86,特异性0.95); 在膝下段 (灵敏度0.78,特异性0.92) 最低.
- 在各个研究中发现了显著的异质性和偏差风险.
结论:
- 双重超声波显示出对症状的外周动脉疾病的良好诊断准确性,特别是在股骨部区域.
- 在膝下部份的业绩不那么可靠,需要进一步调查.
- 现有研究中的异质性和偏见风险凸显了对高质量的研究的需求.
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