超声造影联合剪切波弹性成像技术对肝脏良恶性肿瘤诊断价值的Meta分析

Value of contrast-enhanced ultrasound combined with shear wave elastography in the diagnosis of benign and malignant liver tumors:A Meta-analysis

目的 研究超声造影(CEUS)联合剪切波弹性成像(SWE)对肝脏肿瘤的诊断价值。方法 本研究根据PRISMA指南完成,PROSPERO注册号:CRD42023491288。检索Pub Med、Embase、Cochrane Library、中国知网、维普、万方数据库关于CEUS联合SWE诊断肝脏肿瘤的文献,检索时限为2000年1月—2023年10月,经筛选共纳入12篇文献,包含1 328例患者。以QUADAS-2工具对纳入的文献进行质量评估。采用Stata 15.0软件计算合并灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比及异质性,绘制综合受试者工作特征曲线(SROC)并计算曲线下面积(AUC)。结果 纳入病例中,包含病灶1 457个,其中恶性病灶764个,良性病灶693个,阳性率为52.44%,阴性率为47.56%,计算得到合并灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比分别为0.94(95%CI:0.91~0.96)、0.92(95%CI:0.87~0.95)、12.00(95%CI:7.40~19.40)、0.06(95%CI:0.04~0.10)、191(95%CI:87~417),异质性检验结果为Q=54.78,df=11.00,P<0.001,I2=79.92%,95%CI:69.18%~90.66%,AUC为0.98。结论 CEUS联合SWE技术对于肝脏良恶性肿瘤具有较高的诊断价值,值得临床推广使用。

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)combined with shear wave elastography(SWE)in the diagnosis of liver tumors.Methods This study was conducted according to the PRISMA guideline,with a PROSPERO registration number of CRD42023491288.PubMed,Embase,the Cochrane Library,CNKI,VIP,and Wanfang Data were searched for articles on CEUS combined with SWE in the diagnosis of liver tumors published from January 2000 to October 2023,and a total of 12 articles were included,with 1328 patients in total.The QUADAS-2 tool was used to assess the quality of the articles included.Stata 15.0 software was used to calculate pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and heterogeneity.The summary receiver operating characteristic(SROC)curve was plotted,and the area under the SROC curve(AUC)was calculated.Results There were 1457 lesions for the patients included,among whom there were 764 malignant lesions and 693 benign lesions,with a positive rate of 52.44%and a negative rate of 47.56%.Calculations obtained a pooled sensitivity of 0.94(95%confidence interval[CI]:0.91—0.96),a specificity of 0.92(95%CI:0.87—0.95),a positive likelihood ratio of 12.00(95%CI:7.40—19.40),a negative likelihood ratio of 0.06(95%CI:0.04—0.10),and a diagnostic odds ratio of 191(95%CI:87—417).The tests for heterogeneity showed Q=54.78,df=11.00,P<0.001,and I2=79.92%(95%CI:69.18%—90.66%),with an AUC of 0.98.Conclusion CEUS combined with SWE has a relatively high diagnostic value for benign and malignant liver tumors and thus holds promise for clinical application.