Efficacy of Imaging Methods in the Detection and Diagnosis of Cerebrospinal Fluid Rhinorrhea

医学 磁共振成像 荟萃分析 诊断优势比 脑脊液鼻漏 核医学 鼻漏 放射科 诊断准确性 脑脊液 鞘内 内科学 外科
作者
Se Hwan Hwang,Sun Won Kim,Do Hyun Kim
出处
期刊:Laryngoscope [Wiley]
卷期号:133 (6): 1281-1287 被引量:5
标识
DOI:10.1002/lary.30388
摘要

Objective To assess the diagnostic efficacy of various imaging methods in patients with suspected cerebrospinal fluid (CSF) rhinorrhea. Data Sources The PubMed, EMBASE, SCOPUS, Web of Science, Cochrane Trials, and Google Scholar databases were searched up to December 2021. Review Methods Diagnostic accuracy was compared among seven radiological methods: computed tomography (CT), CT cisternography (CTC), magnetic resonance imaging (MRI), magnetic resonance cisternography (MRC), CT + MRI, radionuclide cisternography, and intrathecal gadolinium (Gd)‐MRC. Sensitivity, specificity, and accuracy were used as outcomes of the analysis. Both a traditional pairwise meta‐analysis and a network meta‐analysis were performed. Results Twenty‐three trials were included in the analysis. The results of a network meta‐analysis performed on a network consisting of seven diagnostic methods showed that all imaging modalities had greater diagnostic accuracy than CT, with the exception of CTC, which had lower sensitivity. Only intrathecal Gd‐MRC was significantly superior to other imaging methods with regard to sensitivity and accuracy. Gd‐MRC also showed the greatest surface under the cumulative ranking curve values for all of the outcomes (sensitivity: 0.9200; specificity: 0.8364; accuracy: 0.8920). Conclusion This network meta‐analysis demonstrates that intrathecal Gd‐MRC is the most useful diagnostic method to detect CSF rhinorrhea. Laryngoscope , 133:1281–1287, 2023

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