剪切波弹性成像诊断甲状腺结节Meta分析

Shear wave elastography in diagnosis of benign and malignant thyroid nodules:A Meta-analysis

目的应用Meta分析评价剪切波弹性成像诊断甲状腺结节的价值。方法计算机检索PubMed、Nature、中国期刊全文数据库CNKI和万方等数据库,收集关于甲状腺结节剪切波弹性成像的中英文文献,根据诊断性试验研究的纳入标准纳入和排除文献,应用Meta-Disc1.4软件对纳入的研究结果进行Meta分析并绘制汇总受试者工作特征（SROC）曲线,计算曲线下面积。结果最终纳入5篇文献、共586个甲状腺病灶,病理结果显示良性结节481个,恶性结节105个。剪切波弹性成像诊断甲状腺结节良恶性的敏感度0.84[95%CI（0.75-0.90）],特异度0.86[95%CI（0.83-0.89）],阳性似然比6.35[95%CI（2.64-15.24）],阴性似然比为0.20[95%CI（0.13-0.31）],诊断比值比31.21[95%CI（12.40-78.53）],诊断试验的SROC曲线下面积为0.9037（Q^＊=0.8353）。结论应用剪切波弹性成像诊断甲状腺结节的敏感度和特异度均较高,能够作为甲状腺结节的无创诊断方法。

Objective To evaluate the value of shear wave elastography（SWE）in the diagnosis of benign and malignant thyroid nodules by Meta-analysis.Methods According to the inclusion and exclusion criteria of diagnostic research,PubMed,Nature,CNKI and WANFANG database were searched for English and Chinese articles related to SWE in the diagnosis of thyroid nodules,and Meta-Disc1.4 software was used to do the Meta analysis,and then the summary receiver operating characteristic（SROC curve）were obtained and analyzed,the area under the curve（AUC）was calculated.Results Totally five studies involving 586 thyroid lesions were considered for the analysis,the pathological results showed that there were 481 benign nodules and 105 malignant nodules.The pooled sensitivity and specificity of SWE in differentiation of benign and malignant thyroid nodules was 0.84（95%CI[0.75-0.90]）and 0.86（95%CI[0.83-0.89]）,respectively,The positive and negative likelihood ratios was 6.35（95%CI[2.64-15.24]）and 0.20（95%CI[0.13-0.31]）,The summary diagnostic odds ratio was 31.21（95%CI[12.40-78.53]）,and the AUC was 0.9037（Q^＊=0.8353）.Conclusion The sensitivity and specificity of SWE in differentiation of benign and malignant thyroid nodules are relatively high,and SWE can be a useful tool for the non-invasive diagnosis of thyroid nodules.