Ultrasonido Doppler con contraste para el diagnóstico de cortocircuito de derecha a izquierda: revisión sistemática y metaanálisis

Medicina Crítica Pub Date : 1900-01-01 DOI:10.35366/94898

Miguel Felipe González Trasviña, U. C. Díaz, Saúl Antonio Villagrana Márquez

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Abstract

Transcranial UD-c was reported in 34 studies, including 2,964 participants (average age 46.8 years, 52% male); for the set of studies, a sensitivity of 95% (95% CI of 0.93-0.97) and specificity of 95% (95% CI of 0.89-0.98) were calculated; likelihood ratio (+) of 8.93 (95% CI of 7.17-11.0), and a Likelihood ratio (-) of 0.08 (95% CI of 0.05-0.12) were also calculated, and when making Bayes’ nomogram, inferring a probability Pre-Test of 30% (prevalence of CDI in general population), a post-test probability is calculated for their respective Likelihood ratio (+) of 79% (CI 0.75-0.82), and a post-test probability for their respective likelihood (-) of 3% (CI 0.02-0.05). Conclusions: The transcranial UD-c is a test with an excellent diagnostic performance when compared to ETE-c, it has the disadvantage of not allowing to differentiate the type of communication (intracardiac or pulmonary). There is not enough evidence to recommend the use of vertebral or carotid UD-c for the diagnosis of CDI; however, current evidence points to a superiority of transcranial UD-c over these. ABSTRACT Introduction: Right to left

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对比多普勒超声诊断从右到左短路:系统综述和荟萃分析

34项研究报告了经颅UD-c，包括2,964名参与者(平均年龄46.8岁，52%为男性);对于这组研究，计算了95%的敏感性(95% CI为0.93-0.97)和95%的特异性(95% CI为0.89-0.98);计算似然比(+)为8.93 (95% CI为7.17-11.0)，似然比(-)为0.08 (95% CI为0.05-0.12)，在制作贝叶斯正态图时，推断Pre-Test的概率为30%(一般人群中CDI的患病率)，计算其各自的似然比(+)为79% (CI 0.75-0.82)，计算其各自的似然比(-)的后验概率为3% (CI 0.02-0.05)。结论:经颅UD-c与et -c相比诊断性能较好，但其缺点是不能区分通信类型(心内或肺)。没有足够的证据推荐使用椎动脉或颈动脉UD-c来诊断CDI;然而，目前的证据表明经颅UD-c优于这些。简介:从右到左

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Medicina Crítica

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