1. Value of contrast-enhanced MR angiography for the follow-up of treated brain arteriovenous malformations: systematic review and meta-analysis.
- Author
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Zhuo, Yudi, Chang, Jingling, Chen, Yi, Wen, Chunli, Chen, Fei, Li, Wenhui, Gao, Mengxia, Luo, Weibo, Wan, Shurun, Song, Lianying, and Zhu, Lingqun
- Subjects
CEREBRAL arteriovenous malformations ,ANGIOGRAPHY ,MAGNETIC resonance angiography ,ARTERIOVENOUS malformation ,SENSITIVITY & specificity (Statistics) - Abstract
Objective: To estimate the diagnostic value of contrast-enhanced MR angiography (CE-MRA) in identifying residual brain arteriovenous malformations (AVMs) after treatment. Methods: We retrieved appropriate references from the electronic databases of PubMed, Web of Science, Embase, and Cochrane Library, and then evaluated the methodology quality of included references using the QUADAS-2 tool. We calculated the pooled sensitivity and specificity by applying a bivariate mixed-effects model and detected the publication bias using Deeks' funnel plot. The values of I
2 were used to test heterogeneity and meta-regression analyses were performed to search for the causes of heterogeneity. Results: We included 7 eligible studies containing 223 participants. Compared with a gold standard, the overall sensitivity and specificity of CE-MRA in detecting residual brain AVMs were 0.77 (95% CI 0.65–0.86) and 0.97 (95% CI 0.82–1.00), respectively. Based on the summary ROC curve, the AUC was 0.89 (95% CI 0.86–0.92). Heterogeneity could be observed in our study, especially for the specificity (I2 = 74.23%). Furthermore, there was no evidence of publication bias. Conclusions: Our study provides evidence that CE-MRA has good diagnostic value and specificity for the follow-up of treated brain AVMs. Nevertheless, considering the small sample size, heterogeneity, and many factors that may affect the diagnostic accuracy, future large-sample, prospective studies are necessary to validate the results. Key Points: • The pooled sensitivity and specificity of contrast-enhanced MR angiography (CE-MRA) in detecting residual arteriovenous malformations (AVMs) were 0.77 (95% CI 0.65–0.86) and 0.97 (95% CI 0.82–1.00). • The four-dimensional CE-MRA showed less sensitivity than the three-dimensional CE-MRA for treated AVMs. • CE-MRA is helpful to identify residual AVMs and reduce excessive DSA during follow-up. [ABSTRACT FROM AUTHOR]- Published
- 2023
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