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目的采用meta分析方法评价超声造影结合超声弹性成像技术在乳腺良恶性病变中的诊断价值。方法检索Pub Med、EMbase、CNKI、VIP、万方等数据库,查找从建库至2016年1月1日期间有关超声造影结合超声弹性成像鉴别乳腺良恶性病变的文献,严格按照纳入、排除标准筛选文献并提取数据、进行质量评估。采用Meta-disc1.4进行异质性分析以及数据合并分析,计算合并敏感性、特异性、阳性似然比、阴性似然比、诊断比值比及其95%CI,绘制森林图、SROC曲线并计算曲线下面积。结果初入选10个研究,1 278个病灶被纳入,经敏感性分析后在9个同质研究内进行统计量的合并,Meta分析数据显示:合并敏感性为0.94[95%CI(0.91~0.96)],特异性为0.92[95%CI(0.89~0.94)],阳性似然比为10.44[95%CI(7.66~14.23)],阴性似然比为0.08[95%CI(0.06~0.11)],诊断比值比为166.38[95%CI(101.91~271.64)],SROC曲线下面积(AUC)为0.974 4,Q指数为0.927 2。结论超声造影技术与超声弹性成像的结合对于鉴别乳腺良恶性病变的诊断准确性较高。
Objective To evaluate the diagnostic value of contrast-enhanced ultrasound and elastography in the diagnosis of benign and malignant breast lesions by meta-analysis. Methods The databases of Pub Med, EMbase, CNKI, VIP and Wanfang were searched to find out the literature about the differential diagnosis of benign and malignant breast lesions by ultrasound contrast and ultrasound elastography from the establishment of the database to January 1, 2016, Literature and data extraction, quality assessment. Meta-disc 1.4 was used for heterogeneity analysis and data consolidation analysis to calculate the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and its 95% CI, and the forest plot and SROC curve were plotted Calculate the area under the curve. RESULTS: Ten studies were initially enrolled and 1 278 lesions were enrolled. Statistical analyzes were performed in nine homogeneous studies after sensitivity analysis. Meta-analysis data showed a combined sensitivity of 0.94 [95% CI (0.91 to 0.96 ) With a specificity of 0.92 [95% CI (0.89-0.94)] and a positive likelihood ratio of 10.44 [95% CI (7.66-14.23)] with a negative likelihood ratio of 0.08 [95% CI ], And the diagnostic odds ratio was 166.38 [95% CI (101.91 ~ 271.64)]. The area under the curve of SROC (AUC) was 0.974 4, and the Q index was 0.927 2. Conclusion The combination of CEUS and ultrasound elastography has a high diagnostic accuracy in differentiating benign and malignant breast lesions.