Accuracy of duplex ultrasound in peripheral artery disease: a systematic review and meta-analysis
Acurácia do ultrassom Doppler na doença arterial periférica: uma revisão sistemática e metanálise
Silfayner Victor Mathias Dias; Ronald Luiz Gomes Flumignan; Nelson Carvas Junior; Wagner Iared
Abstract
Keywords
Resumo
A doença arterial periférica (DAP) nos membros inferiores é altamente prevalente, e as diretrizes atuais recomendam o uso do ultrassom Doppler (UD) com análise espectral para diagnóstico. Esta revisão sistemática e metanálise avaliou a acurácia diagnóstica do UD em pacientes sintomáticos com DAP. Foram pesquisados estudos em bancos de dados eletrônicos que comparassem UD e arteriografia. As artérias foram analisadas individualmente e agrupadas em segmentos: aortofemoral comum, femoropoplíteo, abaixo do joelho e todo o membro inferior. A metanálise estimou sensibilidade, especificidade, verossimilhança e razão de chances diagnóstica (DOR). Quinze estudos foram incluídos, analisando 9.067 artérias. A acurácia do UD para DAP sintomática foi de 0,86 (intervalo de confiança de 95% [IC 95%] 0,81-0,90) para sensibilidade e 0,95 (IC 95% 0,78-0,97) para especificidade. O segmento femoropoplíteo apresentou os melhores resultados, com sensibilidade de 0,86 (IC 95% 0,80-0,90) e especificidade de 0,95 (IC 95% 0,93-0,97). O segmento abaixo do joelho teve o pior desempenho, com sensibilidade de 0,78 (IC 95% 0,60-0,89) e especificidade de 0,92 (IC 95% 0,78-0,97). A maioria dos estudos apresentou risco de viés alto e incerto. Observou-se heterogeneidade significativa nos resultados, com número limitado de estudos primário para cada artéria, especialmente para o segmento abaixo do joelho.
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References
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Submitted date:
05/30/2024
Accepted date:
11/04/2024
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