Meta-analysis of arterial spin labeling MRI to identify residual cerebral arteriovenous malformations after treatment

动脉自旋标记磁共振成像在识别治疗后残留脑动静脉畸形方面的荟萃分析

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Abstract

BACKGROUND: To use of statistical methods to assess the diagnostic value of arterial spin labeling (ASL) imaging for follow-up of treated arteriovenous malformations. METHODS: We screened references from four databases, namely, the Cochrane Library, PubMed, Web of Science and Embase, that met the requirements. The methodology quality of the included studies was evaluated using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Data pertaining to diagnostic performance were extracted, and the pooled sensitivity and specificity were calculated using a bivariate mixed-effects model. RESULTS: We included six studies with a total of 132 patients with arteriovenous malformation (AVM). The merged sensitivity and specificity of ASL for the diagnosis of brain AVMs with incomplete occlusion after treatment were 0.94[0.86-0.98] and 0.99 [0.59-1.00], respectively. According to the SROC curve summary, the AUC was found to be 0.98 [0.96-0.99]. No significant publication bias was observed. CONCLUSION: While ASL does not currently match the diagnostic precision of DSA, it is instrumental in post-treatment surveillance of AVM patients. With the development of ASL technology in the future, this technique holds promise as a minimally invasive diagnostic strategy for AVMs with fewer side effects. REGISTRATION NUMBER OF PROSPERO: CRD42023422087. CLINICAL TRIAL NUMBER: Not applicable.

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