The Diagnostic Test Of Transcranial Doppler Ultrasound In Cerebral Vasospasm After Subarachnoid Hemorrhage

Objective To evaluate the accuracy of transcranial Doppler (TCD) diagnosing cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Method MEDLINE, EMBASE, The Cochrane Library, CNKI were searched from January 1994 to December 2010. We identified blind trials and independent trials. The quality of included trials was evaluated by two estimators. And meta-analysis was conducted on homogeneous studies. Data analysis was processed by Rev Man5.0 and Meta-DiScl.4.Results Eleven (1172 patients) were included. All included studies were blind and independent trials. Meta analysis showed that TCD diagnosis of CVS after SAH 87.04% sensitivity and specificity was 86.32%. The ROC curve is far away from the middle of the diagonal, and very close to the upper left corner, indicating that the accuracy of this diagnostic test is good. The area under the curve was 0.94, closes to the maximum 1. The positive likelihood ratio (PLR) was 6.20.The negative likelihood ratio (NLR) was 0.16 and the diagnostic odds ratio (DOR) was 52.44.Conclusions Transcranial Doppler ultrasound in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage has a good diagnostic accuracy, the diagnostic specificity and sensitivity are high. While there is still a gap compared with the gold standard (Digital subtraction angiography, DSA), but its high diagnostic value does not affect its clinical application.