摘要: |
摘要 目的 本研究旨在比较超声造影(CEUS)与增强CT(CECT)对肾脏肿瘤良恶性的诊断价值。方法 通过在中国知网、万方、PubMed和Embase、The Cochrane Library等数据库中检索建库至2018年12月的合格原始研究。两名评价员独立提取相关数据,并用Stata 14.0软件分别分析CEUS及CECT的灵敏度,特异性,阳性似然比(PLR),阴性似然比(NLR),诊断比值比(DOR)和汇总接受者操作特征(SROC)曲线和曲线下面积(AUC),并探讨异质性的程度和潜在来源。进一步探讨了CEUS与CECT对小肾肿瘤良恶性的诊断价值。结果 共纳入了10项对照研究,1290例病灶,CEUS和CECT检测肾脏肿瘤的合并数据分别为:敏感性(Sen)为0.95(95%置信区间[CI],0.93-0.96)和0.90(95%置信区间[CI],0.85-0.93),特异性(Spe)为0.75(95%CI,0.66-0.83)和0.72(95%CI,0.63-0.80),诊断比值比(DOR)为59(95%CI,35-100)和27(95%CI,19-40),SROC曲线下面积分别为0.95(95%CI,0.93-0.97)和0.89(95%CI,0.86-0.91)。在小肾肿瘤(肿瘤直径<4cm)研究中,CEUS则显示出较高的灵敏度(0.95比0.87),同时CEUS与CECT有着相当的特异度(0.76对0.76)。结论 CEUS在肾脏肿瘤的诊断中,具有与CECT相当的高灵敏度和中等特异性,在小肾肿瘤的诊断中,CEUS的灵敏度更高,表明在肾脏肿瘤的鉴别诊断中,CEUS可作为CECT的替代方法,在临床中推广及研究。 |
关键词: 肾脏肿瘤、超声造影、增强CT、Meta分析 |
DOI: |
投稿时间:2019-08-26修订日期:2019-09-09 |
基金项目: |
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Diagnostic value of contrast-enhanced ultrasound and enhanced CT in renal tumors:A Meta -Analysis |
Ma Hui-bin,Bai-he-ti-ya·Azhati,Li Qian-jin,Zhang Li-dong |
(Department of Urology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China) |
Abstract: |
Abstract:Objective To compare the value of contrast-enhanced ultrasound (CEUS) with enhanced CT (CECT) in the diagnosis of benign and malignant renal tumors.Methods Qualified original research was conducted in the database of China Knowledge Network, Wanfang, PubMed and Embase, The Cochrane Library and other databases until December 2018. Two reviewers independently extracted relevant data and analyzed the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary recipients of CEUS and CECT, respectively, using Stata 14.0 software. Operating characteristics (SROC) curves and area under the curve (AUC), and explore the extent and potential sources of heterogeneity. The diagnostic value of CEUS and CECT for benign and malignant small renal tumors was further explored.Results A total of 10 controlled studies, 1290 lesions, and combined data of CEUS and CECT for renal tumors were included: sensitivity (Sen) was 0.95 (95% confidence interval [CI], 0.93-0.96) and 0.90 ( 95% confidence interval [CI], 0.85-0.93), specificity (Spe) was 0.75 (95% CI, 0.66-0.83) and 0.72 (95% CI, 0.63-0.80), and the diagnostic odds ratio (DOR) was 59 ( 95% CI, 35-100) and 27 (95% CI, 19-40), the area under the SROC curve were 0.95 (95% CI, 0.93-0.97) and 0.89 (95% CI, 0.86-0.91), respectively. In small renal tumors (tumor diameter <4 cm), CEUS showed higher sensitivity (0.95 vs. 0.87), while CEUS and CECT were quite specific (0.76 vs. 0.76).Conclusion CEUS has high sensitivity and moderate specificity in the diagnosis of renal tumors. The sensitivity of CEUS is higher in the diagnosis of small renal tumors, indicating that CEUS can be used as CECT in the differential diagnosis of renal tumors. The alternative method is to promote and study in the clinic. |
Key words: kidney neoplasms, contrast-enhanced ultrasound, enhanced CT, Meta analysis |