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Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis
This meta-analysis summarizes the accuracy of magnetic resonance angiography (MRA) for diagnosing residuals in coiled cerebral aneurysms by using the threefold Roy classification (residuals: none, neck, or sac). Four databases were searched from 2000 to June 2013 for eligible studies that compared M...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973941/ https://www.ncbi.nlm.nih.gov/pubmed/23893001 http://dx.doi.org/10.1007/s00415-013-7053-5 |
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author | Menke, Jan Schramm, Peter Sohns, Jan Martin Kallenberg, Kai Staab, Wieland |
author_facet | Menke, Jan Schramm, Peter Sohns, Jan Martin Kallenberg, Kai Staab, Wieland |
author_sort | Menke, Jan |
collection | PubMed |
description | This meta-analysis summarizes the accuracy of magnetic resonance angiography (MRA) for diagnosing residuals in coiled cerebral aneurysms by using the threefold Roy classification (residuals: none, neck, or sac). Four databases were searched from 2000 to June 2013 for eligible studies that compared MRA to digital subtraction angiography (DSA) and reported 3 × 3 count data of threefold Roy classification, or a reduced scheme of 2 × 2 count data. Bivariate and trivariate Bayesian random-effects models were used for meta-analysis. Among 27 included studies (2,119 coiled aneurysms in 1,809 patients) the average prevalence of DSA-confirmed sac residuals was 18.2 % (range 0–43 %). The pooled sensitivity was 88.0 % (95 % CI 81.4−94.0) and specificity was 97.2 % (94.6−99.0 %) for assessing sac residuals by MRA. In the trivariate meta-analysis, a “sac residual” finding at MRA had a high positive likelihood ratio of 28.2 (14.0–79.0). A “neck residual” finding had a moderate negative likelihood ratio of 0.246 (0.111–0.426), and the MRA finding of “no residual” had a good negative likelihood ratio of 0.044 (0.013–0.096). Subgroup analyses identified no significant influence of covariates on diagnostic accuracy (P > 0.05). In conclusion, in coiled cerebral aneurysms MRA with application of the threefold Roy classification is well suited for detecting or excluding sac residuals that might require retreatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00415-013-7053-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-3973941 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-39739412014-04-07 Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis Menke, Jan Schramm, Peter Sohns, Jan Martin Kallenberg, Kai Staab, Wieland J Neurol Review This meta-analysis summarizes the accuracy of magnetic resonance angiography (MRA) for diagnosing residuals in coiled cerebral aneurysms by using the threefold Roy classification (residuals: none, neck, or sac). Four databases were searched from 2000 to June 2013 for eligible studies that compared MRA to digital subtraction angiography (DSA) and reported 3 × 3 count data of threefold Roy classification, or a reduced scheme of 2 × 2 count data. Bivariate and trivariate Bayesian random-effects models were used for meta-analysis. Among 27 included studies (2,119 coiled aneurysms in 1,809 patients) the average prevalence of DSA-confirmed sac residuals was 18.2 % (range 0–43 %). The pooled sensitivity was 88.0 % (95 % CI 81.4−94.0) and specificity was 97.2 % (94.6−99.0 %) for assessing sac residuals by MRA. In the trivariate meta-analysis, a “sac residual” finding at MRA had a high positive likelihood ratio of 28.2 (14.0–79.0). A “neck residual” finding had a moderate negative likelihood ratio of 0.246 (0.111–0.426), and the MRA finding of “no residual” had a good negative likelihood ratio of 0.044 (0.013–0.096). Subgroup analyses identified no significant influence of covariates on diagnostic accuracy (P > 0.05). In conclusion, in coiled cerebral aneurysms MRA with application of the threefold Roy classification is well suited for detecting or excluding sac residuals that might require retreatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00415-013-7053-5) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2013-07-28 2014 /pmc/articles/PMC3973941/ /pubmed/23893001 http://dx.doi.org/10.1007/s00415-013-7053-5 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Review Menke, Jan Schramm, Peter Sohns, Jan Martin Kallenberg, Kai Staab, Wieland Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title | Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title_full | Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title_fullStr | Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title_full_unstemmed | Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title_short | Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: meta-analysis |
title_sort | diagnosing flow residuals in coiled cerebral aneurysms by mr angiography: meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973941/ https://www.ncbi.nlm.nih.gov/pubmed/23893001 http://dx.doi.org/10.1007/s00415-013-7053-5 |
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