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Prediction of poor outcome after hypoxic-ischemic brain injury by diffusion-weighted imaging: A systematic review and meta-analysis

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  • Ruili Wei
  • Chaonan Wang
  • Fangping He
  • Lirong Hong
  • Jie Zhang
  • Wangxiao Bao
  • Fangxia Meng
  • Benyan Luo

Abstract

Accurate prediction of the neurological outcome following hypoxic–ischemic brain injury (HIBI) remains difficult. Diffusion-weighted imaging (DWI) can detect acute and subacute brain abnormalities following global cerebral hypoxia. Therefore, DWI can be used to predict the outcomes of HIBI. To this end, we searched the PubMed, EMBASE, and Cochrane Library databases for studies that examine the diagnostic accuracy of DWI in predicting HIBI outcomes in adult patients between January1995 and September 2019. Next, we conducted a comprehensive meta-analysis using the Meta-DiSc and several complementary techniques. Following the application of inclusion and exclusion criteria, a total of 28 studies were included with 98 data subsets. The overall sensitivity and specificity, with 95% confidence interval, were 0.613(0.599–0.628) and 0.958(0.947–0.967), respectively, and the area under the curve was 0.9090. Significant heterogeneity among the included studies and a threshold effect were observed (p

Suggested Citation

  • Ruili Wei & Chaonan Wang & Fangping He & Lirong Hong & Jie Zhang & Wangxiao Bao & Fangxia Meng & Benyan Luo, 2019. "Prediction of poor outcome after hypoxic-ischemic brain injury by diffusion-weighted imaging: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-16, December.
    • Handle: RePEc:plo:pone00:0226295
    DOI: 10.1371/journal.pone.0226295
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    1. L.R. Arends & T.H. Hamza & J.C. van Houwelingen & M.H. Heijenbrok-Kal & M.G.M. Hunink & T. Stijnen, 2008. "Bivariate Random Effects Meta-Analysis of ROC Curves," Medical Decision Making, , vol. 28(5), pages 621-638, September.
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