Dados do Trabalho

Título

Comparison of the Diagnostic Performance of Non-contrast MR Angiography and V/Q Scintigraphy for Pulmonary Embolism: A Systematic Review and Meta-Analysis

Descrição sucinta do(s) objetivo(s)

To conduct a meta-analysis of the diagnostic performance of NC-MRPA and V/Q scintigraphy for detection of acute PE.

Descrição da(s) doença(s), método(s) e/ou técnica(s)

Systematic searches of electronic databases were conducted from 2000 to 2023. Primary outcomes were per-patient sensitivity and specificity of NC-MRPA and V/Q scintigraphy. The pooled sensitivities, specificities, and 95% confidence intervals (95% CI) were calculated using a random-effect analysis. Summary receiver-operating characteristic (SROC) curves and the area under the curve (AUC) were obtained.

Discussão

A total of 3345 studies (1695 NC-MRPA studies) were identified through systematic searches, with seven published MRI and nine published V/Q investigations meeting inclusion criteria. The results showed that NC-MRPA had a pooled sensitivity of 0.87 (95%CI,0.82–0.91) and specificity of 0.96 (95%CI,0.93–0.98), yielding an AUC of 0.92 (95% CI 0.85 – 0.96). V/Q scanning had a pooled sensitivity of 0.81 (95% CI 0.76 – 0.85) and specificity of 0.84 (95% CI 0.74 – 0.91), yielding an AUC of 0.87 (95%CI 0.75-0.91). The pooled proportion of non-diagnostic tests for V/Q scans was greater than that of NC-MRPA studies (V/Q, 34.7%, 95%CI, 30.8–38.7; MRI, 3.3% (95% CI, 1.6-5.0).

Conclusões

This meta-analysis suggests that NC-MRPA is more specific than V/Q scintigraphy for detection of PE, with comparable accuracy and sensitivity. NC-MRPA yielded fewer non-diagnostic scans than V/Q scintigraphy and is a feasible alternative imaging modality for diagnosing pulmonary embolism in patients for whom intravenous contrast administration poses substantive risk.

Palavras Chave

Pulmonary Embolism; Meta-Analysis

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