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Diagnostic accuracy...
Diagnostic accuracy of prenatal ultrasound in coarctation of aorta : systematic review and individual participant data meta-analysis
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- Villalaín, C. (författare)
- 12 de Octubre University Hospital
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- D'Antonio, F. (författare)
- University G.d'Annunzio of Chieti-Pescara
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- Flacco, M. E. (författare)
- University of Ferrara
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- Gómez-Montes, E. (författare)
- 12 de Octubre University Hospital
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- Herraiz, I. (författare)
- 12 de Octubre University Hospital
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- Deiros-Bronte, L. (författare)
- La Paz Children's Hospital
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- Maskatia, S. A. (författare)
- Stanford University School of Medicine
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- Phillips, A. A. (författare)
- Stanford University School of Medicine
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- Contro, E. (författare)
- St. Orsola-Malpighi University Hospital
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- Fricke, K. (författare)
- Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital
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- Bhawna, A. (författare)
- Washington University School of Medicine
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- Beattie, M. J. (författare)
- University of California, San Francisco
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- Moon-Grady, A. J. (författare)
- University of California, San Francisco
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- Durand, I. (författare)
- Rouen University Hospital
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- Slodki, M. (författare)
- Polish Mother's Memorial Hospital
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- Respondek-Liberska, M. (författare)
- Medical University of Lodz,Polish Mother's Memorial Hospital
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- Patel, C. (författare)
- The Children's Hospital of Philadelphia
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Kawamura, H. (författare)
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- Rizzo, G. (författare)
- Tor Vergata University Hospital
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- Pagani, G. (författare)
- Papa Giovanni XXIII Hospital
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- Galindo, A. (författare)
- 12 de Octubre University Hospital
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12 de Octubre University Hospital University Gd'Annunzio of Chieti-Pescara (creator_code:org_t)
- 2024
- 2024
- Engelska 11 s.
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Ingår i: Ultrasound in Obstetrics and Gynecology. - 0960-7692. ; 63:4, s. 446-456
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: To determine the diagnostic accuracy of prenatal ultrasound in detecting coarctation of the aorta (CoA). Methods: An individual participant data meta-analysis was performed to report on the strength of association and diagnostic accuracy of different ultrasound signs in detecting CoA prenatally. MEDLINE, EMBASE and CINAHL were searched for studies published between January 2000 and November 2021. Inclusion criteria were fetuses with suspected isolated CoA, defined as ventricular and/or great vessel disproportion with right dominance on ultrasound assessment. Individual participant-level data were obtained by two leading teams. PRISMA-IPD and PRISMA-DTA guidelines were used for extracting data, and the QUADAS-2 tool was used for assessing quality and applicability. The reference standard was CoA, defined as narrowing of the aortic arch, diagnosed after birth. The most commonly evaluated parameters on ultrasound, both in B-mode and on Doppler, constituted the index test. Summary estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and likelihood ratios were computed using the hierarchical summary receiver-operating-characteristics model. Results: The initial search yielded 72 studies, of which 25 met the inclusion criteria. Seventeen studies (640 fetuses) were included. On random-effects logistic regression analysis, tricuspid valve/mitral valve diameter ratio > 1.4 and > 1.6, aortic isthmus/arterial duct diameter ratio < 0.7, hypoplastic aortic arch (all P < 0.001), aortic isthmus diameter Z-score of < −2 in the sagittal (P = 0.003) and three-vessel-and-trachea (P < 0.001) views, pulmonary artery/ascending aorta diameter ratio > 1.4 (P = 0.048) and bidirectional flow at the foramen ovale (P = 0.012) were independently associated with CoA. Redundant foramen ovale was inversely associated with CoA (P = 0.037). Regarding diagnostic accuracy, tricuspid valve/mitral valve diameter ratio > 1.4 had a sensitivity of 72.6% (95% CI, 48.2–88.3%), specificity of 65.4% (95% CI, 46.9–80.2%) and DOR of 5.02 (95% CI, 1.82–13.9). The sensitivity and specificity values were, respectively, 75.0% (95% CI, 61.1–86.0%) and 39.7% (95% CI, 27.0–53.4%) for pulmonary artery/ascending aorta diameter ratio > 1.4, 47.8% (95% CI, 14.6–83.0%) and 87.6% (95% CI, 27.3–99.3%) for aortic isthmus diameter Z-score of < –2 in the sagittal view and 74.1% (95% CI, 58.0–85.6%) and 62.0% (95% CI, 41.6–78.9%) for aortic isthmus diameter Z-score of < –2 in the three-vessel-and-trachea view. Hypoplastic aortic arch had a sensitivity of 70.0% (95% CI, 42.0–88.6%), specificity of 91.3% (95% CI, 78.6–96.8%) and DOR of 24.9 (95% CI, 6.18–100). The diagnostic yield of prenatal ultrasound in detecting CoA did not change significantly when considering multiple categorical parameters. Five of the 11 evaluated continuous parameters were independently associated with CoA (all P < 0.001) but all had low-to-moderate diagnostic yield. Conclusions: Several prenatal ultrasound parameters are associated with an increased risk for postnatal CoA. However, diagnostic accuracy is only moderate, even when combinations of parameters are considered.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- aortic arch anomaly
- coarctation of the aorta
- meta-analysis
- prenatal diagnosis
- systematic review
- ultrasound
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Till lärosätets databas
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Villalaín, C.
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D'Antonio, F.
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Flacco, M. E.
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Gómez-Montes, E.
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Herraiz, I.
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Deiros-Bronte, L ...
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visa fler...
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Maskatia, S. A.
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Phillips, A. A.
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Contro, E.
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Fricke, K.
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Bhawna, A.
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Beattie, M. J.
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Moon-Grady, A. J ...
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Durand, I.
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Slodki, M.
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Respondek-Libers ...
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Patel, C.
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Kawamura, H.
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Rizzo, G.
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Pagani, G.
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Galindo, A.
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visa färre...
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