| Using Meta-analysis to compare diagnostic value of contrast transcranial Doppler
(c-TCD) and contrast transthoracic echocardiography (c-TTE) in right-to-left shunt (RLS) of patients with patent
foramen ovale (PFO). Methods: Relevant literature from PubMed, Web of Science, Embase, Cochrane Library,
CNKI, VIP, WanFang Data, and CBM from databases built until July 3, 2021 were retrieved. Statistical software
Stata 15.1 and RevMan5.0 were used for statistical analysis. Results: A total of 766 articles were retrieved and
38 were included. Meta-analysis results showed the overall sensitivity of c-TCD (0.96, 95%CI 0.93～0.98) was
higher than that of c-TTE (0.91, 95%CI 0.82 ~ 0.96), and the difference was statistically significant (Z=2.664, P= 0.008). The overall specificity of c-TCD (0.93, 95%CI 0.86～0.97) was lower than that of c-TTE (0.95, 95%CI 0.90 ~ 0.97), but the difference was not statistically significant (Z=0.481, P=0.630). The diagnostic odds ratio of
c-TCD (DOR=384, 95%CI 156～943) and c-TTE (DOR=180, 95%CI 78～415) showed no significant statistical
difference (Z=0.674, P=0.441). The area under the sROC curve (AUC) of c-TCD was higher than that of c-TTE
but showed no statistical difference (AUC=0.99, 95%CI 0.97～0.99 for c-TCD v.s. AUC=0.98, 95%CI 0.96～ 0.99 for c-TTE; Z=0.357, P=0.507). Conclusion: For the diagnosis of PFO-RLS, both c-TCD and c-TTE have
high diagnostic value. |