scholarly journals Diagnostic Value of MRA and MRI for The Articular-Sided Partial-Thickness Rotator Cuff Tears: A Meta-Analysis

2020 ◽  
Author(s):  
Lianxin Li ◽  
Jinlei Dong ◽  
Qinghu Li ◽  
Jinye Dong ◽  
Dongsheng Zhou ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Mr Arthrography ◽  
Diagnostic Value ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Initial Examination ◽  
Partial Thickness ◽  
Sensitivity Specificity

Abstract Background: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT).Methods: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under receiver operating characteristic curve (AUC). Results: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65-0.90), 0.96 (95% CI, 0.91-0.98), 68.14 (95% CI, 33.20-139.84) and 0.96 (95% CI, 0.94-0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65-0.87) and 0.97 (95% CI, 0.84-0.99), 47.82 (95% CI, 8.29-275.89) and 0.89 (95% CI, 0.86-0.92), respectively.Conclusions: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears, but only small improvement of sensitivity. Considering the price and invasion of MRA, MRI is recommended as an initial examination to detect patients suspected with articular-side partial-thickness rotator cuff tears.

scholarly journals Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Tao Huang ◽  
Jian Liu ◽  
Yupeng Ma ◽  
Dongsheng Zhou ◽  
Liang Chen ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Mr Arthrography ◽  
Diagnostic Value ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Predictive Values ◽  
Partial Thickness ◽  
Sensitivity Specificity

Abstract Background Numerous quantitatively studies have focused on the diagnosis of bursal-sided partial-thickness rotator cuff tears (RCTs); however, the accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) remains inconclusive. This study was performed systematically to compare the diagnostic value of MRA and MRI for the bursal-sided partial-thickness RCTs. Methods Three electronic databases, PubMed, Embase, and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting bursal-sided partial-thickness RCTs. After screening and diluting out the articles that met the inclusion criteria to be used for statistical analysis, the pooled evaluation indexes include sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC). Results Twelve studies involving 1740 patients and 1741 shoulders were identified. The pooled sensitivity, specificity, DOR, and AUC of MRA to diagnose bursal-sided partial-thickness RCTs were 0.77 (95% CI, 0.67–0.85), 0.98 (95% CI, 0.95–0.99), 73.01 (95% CI, 35.01–152.26), and 0.88 (95% CI, 0.85–0.91), respectively. The pooled sensitivity, specificity, DOR, and AUC of MRI were 0.77 (95% CI, 0.66–0.86) and 0.96 (95% CI, 0.81–0.99), and 37.12 (95% CI, 8.08–170.64) and 0.82 (95% CI, 0.78–0.85), respectively. Conclusions This meta-analysis reveals that MRA and MRI have similar diagnostic value for the diagnosis of bursal-sided partial-thickness rotator cuff tears.

scholarly journals MRA improves sensitivity than MRI for the articular-sided partial-thickness rotator cuff tears

2021 ◽  
Vol 104 (4) ◽  
pp. 003685042110599
Author(s):  
Lianxin Li ◽  
Jinlei Dong ◽  
Qinghu Li ◽  
Jinye Dong ◽  
Bingzhi Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Mr Arthrography ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Partial Thickness ◽  
Sensitivity Specificity

Background: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT). Methods: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under the receiver operating characteristic curve (AUC). Results: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65–0.90), 0.96 (95% CI, 0.91–0.98), 68.14 (95% CI, 33.20–139.84) and 0.96 (95% CI, 0.94–0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65–0.87) and 0.97 (95% CI, 0.84–0.99), 47.82 (95% CI, 8.29–275.89) and 0.89 (95% CI, 0.86–0.92), respectively. Conclusions: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears because of an improvement of sensitivity.

scholarly journals Diagnostic Accuracy of Ultrasonography for Rotator Cuff Tears: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110351
Author(s):  
Ali S. Farooqi ◽  
Alexander Lee ◽  
David Novikov ◽  
Ann Marie Kelly ◽  
Xinning Li ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Diagnostic Accuracy ◽  
Biceps Tendon ◽  
Meta Analysis ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Diagnostic Values ◽  
Tendon Tears ◽  
Sensitivity Specificity

Background: With recent improvements in transducer strength, image resolution, and operator training, ultrasound (US) provides an excellent alternative imaging modality for the diagnosis of rotator cuff tears. Purpose: To evaluate the diagnostic accuracy of US for partial- and full-thickness rotator cuff tears and biceps tendon tears, compare diagnostic values with those of magnetic resonance imaging (MRI) using arthroscopy as the reference standard, assess longitudinal improvements in accuracy, and compare diagnostic values from operators with different training backgrounds. Study Design: Systematic review; Level of evidence, 3. Methods: The PubMed and Cochrane Library databases were systematically searched for full-text journal articles published between January 1, 2010, and April 1, 2020. The inclusion criteria were studies that evaluated the diagnostic accuracy of US for rotator cuff tears or biceps tendon tears utilizing arthroscopy as the reference standard. The exclusion criteria were studies with <10 patients, studies including massive tears without reporting diagnostic data for specific tendons, and studies lacking diagnostic outcome data. Extracted outcomes included diagnostic accuracy, sensitivity, specificity, negative predictive value, and positive predictive value. The mean difference and 95% confidence interval were calculated for both US and MRI diagnostic values, and meta-analysis was conducted using the Mantel-Haenszel random-effects model. Results: In total, 23 eligible studies involving 2054 shoulders were included. US demonstrated a higher median diagnostic accuracy for supraspinatus tendon tears (0.83) and biceps tendon tears (0.93) as compared with subscapularis tendon tears (0.76). US was found to have a higher median accuracy (0.93) for full-thickness supraspinatus tears than partial-thickness tears (0.81). US had superior median sensitivity for partial-thickness supraspinatus tears when performed by radiologists as opposed to surgeons (0.86 vs 0.57). Meta-analysis of the 5 studies comparing US and MRI demonstrated no statistically significant difference in diagnostic sensitivity, specificity, or accuracy for any thickness supraspinatus tears (P = .31-.55), full-thickness tears (P = .63-.97), or partial-thickness tears ( P = .13-.81). Conclusion: For experienced operators, US is a highly sensitive and specific diagnostic modality for the diagnosis of supraspinatus tears and demonstrates statistically equivalent capability to MRI in the diagnosis of both full- and partial-thickness rotator cuff tears.

scholarly journals Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Surgical Correction ◽  
Statistical Testing ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Linear Probe ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

scholarly journals The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weixing Liu ◽  
Gui Chen ◽  
Xin Gong ◽  
Yingqi Wang ◽  
Yaoming Zheng ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Test Performance ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Control Group ◽  
Summary Receiver Operating Characteristic ◽  
Ebv Dna ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Background Numerous individual studies have investigated the diagnostic value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection for nasopharyngeal carcinoma (NPC), but the conclusions remain controversial. This meta-analysis aimed to determine the value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection in the diagnosis of NPC. Methods PROSPERO registration number: CRD42019145532. PubMed, EMBASE, Cochrane Library, and Chinese data libraries (Wanfang, CNKI, and CBM) were searched up to January 2019. The pooled sensitivity, specificity, and positive likelihood, negative likelihood, and diagnostic odds ratios were conducted in this meta-analysis. Summary receiver operating characteristic curves evaluated the test-performance global summary. Publication bias was examined by Deek’s funnel plot asymmetry test. Results Forty-seven studies with 8382 NPC patients (NPC group) and 15,089 individuals without NPC (Control group) were included in this meta-analysis. The sensitivity, specificity, positive likelihood (+ LR), negative likelihood (-LR), DOR and AUC of EBV-DNA in diagnosis of NPC were: 0.76 (95% CI 0.73–0.77), 0.96 (95% CI 0.95–0.97), 14.66 (95% CI 9.97–21.55), 0.19 (95% CI 0.13–0.28), 84 (95% CI 50.45–139.88), 0.96 (SE: 0.001), and 0.55 (95% CI 0.54–0.57), 0.96 (95% CI 0.96–0.97), 12.91 (95% CI 9.55–17.45), 0.35 (95% CI 0.29–0.43), 39.57 (95% CI 26.44–59.23), 0.94 (SE: 0.002) for the EA-IgA, and 0.85 (95% CI 0.84–0.85), 0.89 (95% CI 0.88–0.89), 6.73 (95% CI5.38–8.43), 0.17 (95% CI 0.12–0.23), 43.03 (95% CI 31.51–58.76), 0.93 (SE: 0.007) for the VCA-IgA, and 0.86 (95% CI 0.85–0.88), 0.87 (95% CI 0.88–0.90), 7.55 (95% CI 5.79–9.87), 0.16 (95% CI 0.13–0.19), 50.95 (95% CI 34.35–75.57), 0.94 (SE: 0.008) for the EBNA1-IgA, and 0.70 (95% CI 0.69–0.71), 0.94 (95% CI 0.94–0.95), 9.84 (95% CI 8.40–11.54), 0.25 (95% CI 0.21–0.31), 40.59 (95% CI 32.09–51.35), 0.95 (SE: 0.005) for the Rta-IgG. The EBV-DNA had larger AUC compared with other EBV-based antibodies (P < 0.05), while the difference between EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG was not statistically significant (P > 0.05). Conclusions EBV-DNA, VCA-IgA, EBNA1-IgA and Rta-IgG detection have high accuracy in early diagnosis NPC. In addition, EBV-DNA detection has the higher diagnosis accuracy in NPC. On the other hand, EA-IgA is suitable for the diagnosis but not NPC screening.

Accuracy of MRI, MR Arthrography, and Ultrasound in the Diagnosis of Rotator Cuff Tears: A Meta-Analysis

2009 ◽  
Vol 192 (6) ◽  
pp. 1701-1707 ◽  
Author(s):  
Joseph O. de Jesus ◽  
Laurence Parker ◽  
Andrea J. Frangos ◽  
Levon N. Nazarian
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Mr Arthrography ◽  
Rotator Cuff Tears

scholarly journals Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis

2020 ◽  
Vol 22 (2) ◽  
pp. 197 ◽  
Author(s):  
Weiyu Liang ◽  
Huaiyu Wu ◽  
Fajin Dong ◽  
Hongtian Tian ◽  
Jinfeng Xu
Keyword(s):  
Rotator Cuff ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
High Efficiency ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Diagnostic Odds Ratio ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Summary Receiver Operating Characteristic

Aim: Rotator cuff (RC) tears are considered to be the main reason for shoulder pain. Although ultrasound is a useful method to detect it, its effectiveness when diagnosing RC tears has been a heated discussion. Therefore, we aimed at evaluating RC tears’ ultrasound accuracy by conducting a systemically review and pooled comprehensive analysis.Materials and methods: Relevant articles up to May 2018 were searched from the Cochrane Library, Embase, and Pubmed databases. Either arthroscopy or magnetic resonance imaging (MRI) was considered as a reference standard. The results were estimated by pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-diagnostic odds ratio (P-DOR), pooled-likelihood ratio+ (PLR+), pooled-likelihood ratio- (P-LR-), and the area under the summary receiver operating characteristic (SROC).Result: We selected seven prospective studies in accordance with the inclusion criteria that covered 554 rotator cuff tears in 868 patients. The P-SEN, P-SPE, P-LR+, P-LR-, P-DOR, area under the SROC curve of diagnostic performance of ultrasound for RC and post-test probability were 95% (95% CI: 88 – 98), 72% (95% CI: 61 – 81), 3.41 (95% CI: 2.40 – 4.84), 0.08 (95% CI: 0.03 – 0.16), 45.31 (95% CI: 21.04 – 97.59), 89% (95% CI: 0.86 – 0.91), and 46% and 2%, respectively.Conclusion: Our metaanalysis demonstrates that ultrasound has a high efficiency for RC tears’ diagnosis. It can be a promising method in patients with suspected RC tears because of its high sensitivity, specificity and diagnostic accuracy.

scholarly journals Diagnostic Value of Circulating microRNAs in Laryngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Danni Cheng ◽  
Wendu Pang ◽  
Ke Qiu ◽  
Wenjie Yang ◽  
Yufang Rao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Abstract Background : Circulating microRNAs (miRNAs) play an important role in the biological processes of cancers and are promising biomarkers of cancer diagnosis. Objectives : To estimate the diagnostic value of microRNAs in laryngeal squamous cell carcinoma (LSCC) patients, comparing with the non-LSCC controls. Population : Six eligible LSCC studies including 1,585 LSCC patients with corresponding 2,095 non-LSCC controls from years 2000 to 2017 were analyzed. Methods : Medline, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, EMBASE, Cochrane Library and Web of Science were searched in this study. We conducted a meta-analysis to identify studies that reported the diagnostic data of miRNAs both in LSCC patients and controls. I n addition, we evaluated and compared the diagnostic value of upregulated miRNAs with downregulated miRNAs . Results : Six studies with corresponding specificity and sensitivity data were included in this study. The pooled sensitivity, specificity and AUC were 0.89 (95% CI: 0.79-0.94), 0.87 (95% CI: 0.77-0.93), and 0.94 (95% CI: 0.92-0.96), respectively. However, the heterogeneities of these studies were quite high, the value of I 2 for the pooled sensitivity, specificity were 96.82% and 97.08%, respectively. Subgroup analysis of upregulated and downregulated miRNAs showed a similar diagnostic value but the heterogeneity remained high. Publication bias was found in Funnel plot of pooled and upregulated miRNAs, while not obvious in downregulated miRNAs. Conclusions : Circulating miRNAs showed diagnostic significance in laryngeal cancer, however, the results of this meta-analysis revealed significant heterogeneity. Therefore, the diagnostic value of miRNAs in LSCC seems limited.

scholarly journals Meta-analysis of the diagnostic value of Wisteria floribunda agglutinin-sialylated mucin1 and the prognostic role of mucin1 in human cholangiocarcinoma

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e021693 ◽  
Author(s):  
Zengwei Tang ◽  
Yuan Yang ◽  
Xiaolu Wang ◽  
Wenbo Meng ◽  
Xun Li
Keyword(s):  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
P Value ◽  
Analysis Model ◽  
Prognostic Role ◽  
Wisteria Floribunda

ObjectiveSerum carbohydrate antigen 19–9 (CA19-9) is a widely used tumour marker for cholangiocarcinoma (CCA). However, it is not a necessarily good CCA marker in terms of diagnostic accuracy. The purpose of this study is to evaluate the diagnostic value ofWisteria floribundaagglutinin-sialylated Mucin1 (WFA-MUC1) and the prognostic role of Mucin1 (MUC1) in human CCA.DesignMeta-analysis.Data sourcesStudies published in PubMed, Web of Science, The Cochrane Library and the China National Knowledge Infrastructure up to 11 October 2017.Eligibility criteriaWe included reports assessing the diagnostic capacity of WFA-MUC1 and the prognostic role of MUC1 in CCA. The receiver operating characteristic curve (ROC) of WFA-MUC1 and/or CA19-9 was described, and the HRs including 95% CI and the corresponding p value for MUC1 can be extracted.Data extraction and synthesisTwo independent researchers extracted data and assessed risk of bias. The diagnostic sensitivity and specificity data of WFA-MUC1 were extracted and analysed as bivariate data. Pooled HRs and its 95% CI for MUC1 were calculated with a random-effects meta-analysis model on overall survival of resectable CCA.ResultsSixteen reports were included in this study. The pooled sensitivity and specificity of WFA-MUC1 were 0.76 (95% CI 0.71 to 0.81) and 0.72 (95% CI 0.59 to 0.83) in serum, 0.85 (95% CI 0.81 to 0.89) and 0.72 (95% CI 0.64 to 0.80) in bile and 0.72 (95% CI 0.50 to 0.87) and 0.85 (95% CI 0.70 to 0.93) in tissue, respectively. The summary ROC (SROC) were 0.77 (95% CI 0.73 to 0.81) in serum, 0.88 (95% CI 0.85 to 0.90) in bile and 0.86 (95% CI 0.83 to 0.89) in tissue, respectively. Furthermore, the pooled sensitivity and specificity and the SROC of CA19-9 in serum were 0.67 (95% CI 0.61 to 0.72), 0.86 (95% CI 0.75 to 0.93) and 0.75 (95% CI 0.71 to 0.79), respectively. The pooled HRs for MUC1 was 2.20 (95% CI 1.57 to 3.01) in CCA and 4.17 (95% CI 1.71 to 10.17) in mass-forming intrahepatic CCA.ConclusionsCompared with CA19-9, WFA-MUC1 was shown to possess stronger diagnostic capability. MUC1 could serve as a prognosis factor for poor outcomes of CCA, particularly, mass-forming intrahepatic CCA.

scholarly journals Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hao Wang ◽  
Ying Ba ◽  
Qian Xing ◽  
Run-Ce Cai
Keyword(s):  
Differential Diagnosis ◽  
Likelihood Ratio ◽  
Cushing Syndrome ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Published Data ◽  
Inferior Petrosal Sinus ◽  
Inferior Petrosal Sinus Sampling ◽  
Sensitivity Specificity

Abstract Background: Previous studies have shown inconsistent results in the differential diagnosis obtained from bilateral inferior petrosal sinus sampling (BIPSS) in adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. Methods: This study searched PubMed, Embase, Web of Science, the Cochrane library, and the Wanfang database for published data on the differential diagnosis obtained using BIPSS in Cushing syndrome as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data. Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively. Conclusion: This meta-analysis indicated that BIPSS had a highly diagnostic value for ACTH originally in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as a routine method to identify ACTH sources. Keywords: Bilateral inferior petrosal sinus sampling, ACTH-dependent Cushing syndrome, Differential diagnosis , Diagnostic meta-analysis

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