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

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