Computed tomography versus transthoracic echocardiography in the detection of complex congenial heart diseases in china:a meta-analysis

摘要

Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography (CT) and transthoracic echocardiography (TTE) in complex congenital heart diseases (CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure (CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the "gold-standard" (15 studies,XX patients) were collected.The statistic software package,"Meta-Disc 1.4",was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval (CI):94%~96%] for CT studies and 87% (95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant (P<0.001).TTE had higher sensitivity [0.96 (95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78 (95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.