| 摘要: |
| 【摘要】 目的：系统评价超声造影(CEUS)与增强磁共振(CE-MRI)在乳腺良恶性肿块鉴别诊断中的临床价值。方法：系统检索PubMed、EMBASE、Cochrane Library、CNKI、CBM 及万方等数据库,纳入以CEUS与CE-MRI技术分别鉴别诊断同一组乳腺肿块良恶性的研究严格按照纳入、排除标准进行文献筛选、数据提取及方法学质量评价。采用STATA 14.0 软件检测异质性,计算敏感性、特异性、阳性似然比、阴性似然比及诊断比值比进行合并分析；绘制汇总森林图和受试者工作特征曲线(SROC)图,计算曲线下面积AUROC；绘制Fagan 图,进行敏感性和漏斗图分析。结果共纳入14篇文献,共计1153个乳腺肿块。CEUS与CE-MRI对乳腺恶性肿块诊断的合并敏感性和合并特异性分别为0.85(95%CI：0.82～0.88)、0.80(95%CI：0.76～0.84)和0.81(95%CI：0.77～0.84)、0.77(95%CI：0.70～0.82)；SROC 曲线下面积分别为0.90(95%CI：0.87～0.92)、0.86(95%CI：0.82～0.89),二者诊断效能比较差异均有统计学意义(均P＜0.05)。各研究稳定性较好,未见明显发表偏倚(P＞0.05)。结论 CEUS 对乳腺肿块良恶性鉴别诊断效能较CE-MRI略高,但两者对乳腺肿块良恶性的诊断均有重要意义,是乳腺诊断的重要影像学手段。 |
| 关键词: 超声造影 造影剂 增强磁共振 乳腺肿块 Meta分析 |
| DOI： |
| 投稿时间：2018-04-22修订日期：2018-04-22 |
| 基金项目:江苏省卫生计生委科研课题项目(H201534) |
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| Contrast－enhanced ultrasonography and Contrast -enhanced Magnetic Resonance Imaging in diagnosis of benign and malignant breast lumps: a Meta－analysis |
| YangBingjie,Lijia |
| () |
| Abstract: |
| 【Abstract】 Objective： To systematically and comparatively evaluate the clinical value of contrast－enhanced ultrasonography(CEUS)and magnetic resonance imaging(CE-MRI)in differential diagnosis of benign and malignant breast lumps. Methods Databases including PubMed,EMBASE,Cochrane Library、CNKI、CBM and WanFang were electronically searched for differential diagnosis research reports of benign and malignant breast lumps by CEUS and CE-MRI in the same group of breast lumps, The reviewers strictly followed the inclusion and exclusion criteria to screen the literature, extract data, and assess the methodological quality, the heterogeneity was detected by STATA 14.0 software, according to the bivariate mixed effects model, the sensitivity, specificity, positive and negative likelihood ratio and diagnostic odds ratio were meta analyzed, the forest map, the summary receiver operating characteristic(SROC)curves, Fagan graphs were produced, the area under the curves(AUROC)were also calculated. The analysis of sensitivity was performed and publication bias was analyzed with Deek funnel plot. Results :A total of 14 studies(1153 lumps)were included. The pooled sensitivity and specificity were 0.85(95%CI：0.82～0.88),0.80(95%CI：0.76～0.84),and 0.81(95%CI：0.77～0.84),0.77(95%CI：0.70～0.82),the area under the curves were 0.90(95%CI：0.87～0.92),0.86(95%CI：0.82～0.89)respectively .There was significant difference of diagnostic efficiency between the methods(P<0.05).Sensitivity analysis demonstrated no disproportionate influences of individual studies. Deeks funnel plot suggested the publication bias was not significant(P＞0.05). Conclusion In the diagnosis of benign and malignant breast lumps,the diagnostic efficiency of CEUS is better than MRI, however,both of them have high clinical value in diagnosis. |
| Key words: Contrast-enhanced ultrasound Contrast agent CE-MRI Breast lumps Meta－analysis |
