Computed tomography (CT)–derived extracellular volume fraction (ECV) is a noninvasive method to quantify myocardial fibrosis. Although studies suggest CT is a suitable measure of ECV, clinical use remains limited. A meta-analysis was performed to determine the clinical value of CT-derived ECV in cardiovascular diseases. Electronic database searches of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE were performed. The most pivotal analysis entailed the comparison of ECV ascertained through CT-ECV among the control, aortic stenosis, and cardiac amyloidosis cohorts. The diagnostic test accuracy for detecting cardiac amyloidosis was assessed using summary receiver-operating characteristics curve. Pooled CT-derived ECV values were 28.5% (95% CI: 27.3%-29.7%) in the control, 31.9% (95% CI: 30.2%-33.8%) in the aortic stenosis, and 48.9% (95% CI: 44.5%-53.3%) in the cardiac amyloidosis group. ECV was significantly elevated in aortic stenosis ( 0.002) (vs controls) but further elevated in cardiac amyloidosis ( 0.001) (vs aortic stenosis). CT-derived ECV had a high diagnostic accuracy for cardiac amyloidosis, with sensitivity of 92.8% (95% CI: 86.7%-96.2%), specificity of 84.8% (95% CI: 68.6%-93.4%), and area under the summary receiver-operating characteristic curve of 0.94 (95% CI: 0.88-1.00). This study is the first comprehensive systematic review and meta-analysis of CT-derived ECV evaluation in cardiac disease. The high diagnostic accuracy of CT-ECV suggests the usefulness of CT-ECV in the diagnosis of cardiac amyloidosis in preoperative CT planning for transcatheter aortic valve replacement.

中文翻译：

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计算机断层扫描心肌细胞外容量分数的临床实用性：系统评价和荟萃分析

计算机断层扫描 (CT) 衍生的细胞外体积分数 (ECV) 是一种量化心肌纤维化的无创方法。尽管研究表明 CT 是 ECV 的合适测量方法，但临床应用仍然有限。进行荟萃分析以确定 CT 衍生的 ECV 在心血管疾病中的临床价值。对 PubMed、Web of Science 核心合集、Cochrane 高级检索和 EMBASE 进行了电子数据库检索。最关键的分析需要比较通过 CT-ECV 在对照组、主动脉瓣狭窄和心脏淀粉样变性队列中确定的 ECV。使用总结的接受者操作特征曲线评估检测心脏淀粉样变性的诊断测试的准确性。对照组的汇总 CT 衍生 ECV 值为 28.5% (95% CI: 27.3%-29.7%)，主动脉瓣狭窄为 31.9% (95% CI: 30.2%-33.8%)，主动脉瓣狭窄为 48.9% (95% CI: 27.3%-29.7%)。 44.5%-53.3%)在心脏淀粉样变组中。主动脉瓣狭窄 (0.002)（相对于对照组）的 ECV 显着升高，但心脏淀粉样变性 (0.001)（相对于主动脉瓣狭窄）进一步升高。 CT 衍生的 ECV 对心脏淀粉样变性具有较高的诊断准确性，敏感性为 92.8%（95% CI：86.7%-96.2%），特异性为 84.8%（95% CI：68.6%-93.4%），面积受试者工作特征曲线总结为 0.94（95% CI：0.88-1.00）。本研究是首次对心脏病中 CT 衍生的 ECV 评估进行全面的系统回顾和荟萃分析。 CT-ECV 的高诊断准确性表明 CT-ECV 在经导管主动脉瓣置换术术前 CT 计划中诊断心脏淀粉样变性中的有用性。