实时超声弹性成像对涎腺结节良恶性诊断的Me ta分析

摘要

目的：系统评价实时超声弹性成像中的弹性评分法对于区分涎腺结节良恶性的诊断价值。方法：计算机检索PubMed、Embase、High Wire Press、Ovid、中国学术期刊网全文数据库（CNKI）至2016年5月31日，检索语言为英文和中文。选取应用超声弹性评分法区别涎腺结节良恶性的文章。合并敏感度、特异度、诊断比值比（DOR）评价超声弹性评分法区别涎腺结节的诊断准确性。进行综合接受者工作特征曲线（SROC），计算曲线下面积（AUC）和Q*值来分析超声弹性评分法区别涎腺结节的综合诊断价值。结果：最终纳入11篇研究，包含642名患者，共计691个结节。超声弹性评分法区别涎腺结节的合并敏感度、特异度、诊断比值比分别为：0．77（95％CI：0．68～0．84），0．74（95％CI：0．65～0．82），10．12（95％CI：4．67～21．94）。综合SROC曲线下面积为0．82，Q*指数为0．7623。结论：实时超声弹性对于诊断腮腺及颌下腺结节的良恶性方面有一定的诊断价值，它可以作为一个辅助工具与传统超声联合使用，提高腮腺及颌下腺结节诊断的准确度。%Objective:To evaluate the performance of real -time ultrasound elastography for differentiation be-tween benign and malignant salivary gland nodules.Methods:Extensive literature searches were from PubMed,Em-base,High Wire Press,Ovid and CNKI,up to May 31,2016.Clinical trials utilizing elasticity score to differentiate be-tween benign and malignant salivary gland nodules were selected.Pooled sensitivity,specificity and diagnostic odds ra-tio(DOR)for real-time elastography were analyzed.Summary receiver operating characteristic (SROC)curves were also constructed.Results:1 1 studies,a total of 69 1 nodules in 642 patients were analyzed .The overall mean sensi-tivity,specificity,diagnostic odds ratio(DOR)for the elasticity score were 0.77 (95%CI:0.68 ~0.84),0.74 (9 5%CI:0 .6 5 ~0 .8 2 ),1 0 .1 2 (9 5%CI:4 .6 7 ~2 1 .9 4 ).The area under the curve for the elasticity score was 0.82(Q* =0.762 3).Conclusion:Ultrasound elastography has moderate sensitivity and specificity for identifica-tion of salivary gland nodules.