剪切波弹性模量鉴别乳腺良恶性肿块的Meta分析

摘要

Objective To assess the value of shear-wave elastic modulus for differential diagnosis of benign and malignant breast lesions using Meta-analysis.Methods Relevant Chinese and foreign articles about shear-wave elastography for differentiating benign and malignant breast lesions were collected from the literatures published before Apr.2016.Meta-analysis was conducted to assess the overall ability of the shear wave elastic modulus including Emax,Emea,Eratio and Esd.Results Totally 31 studies were brought into the Meta-analysis.The summarized sensitivity (SSEN) and summarized specificity (SSPE) of Emax were 0.87(95％CI [0.83,0.91]) and 0.91 (95％CI [0.87,0.93]).The SSEN and SSPE of Emea were 0.84 (95％CI [0.77,0.89]) and 0.88 (95％CI [0.84,0.91]),The SSEN and SSPE of Eratio were 0.88(95％CI [0.83,0.91]) and 0.87 (95％CI [0.80,0.91],the SSEN and SSPE of gsd were 0.85 (95％CI [0.80,0.89]) and 0.90 (95％CI [0.85,0.94]).The summarized receiver operator characteristic analysis showed that the area under the curve of E E Eratio and Esd were 0.95,0.93,0.93 and 0.93.Conclusion The shear wave elastic modulus contribute to differentiate benign and malignant breast lesions.Among these indices,Emax is the best one.%目的 采用Meta分析评价剪切波弹性模量鉴别乳腺良恶性肿块的价值.方法 检索2016年4月前有关剪切波弹性成像鉴别诊断乳腺良恶性肿块的中文及英文文献.通过Meta分析评价弹性模量参数(Emax、Eea、Eratio、Esd)鉴别诊断乳腺良恶性肿块的效能.结果 共纳入文献31篇.弹性模量Emax的合并敏感度(SSEN)为0.87[95％CI(0.83,0.91)],合并特异度(SSPE)为0.91[95％CI(0.87,0.93)];Emea的SSEN为0.84[95％CI(0.77,0.89)],SSPE为0.88[95％CI(0.84,0.91)];Eratio的SSEN为0.88[95％CI(0.83,0.91)],SSPE为0.87[95％CI(0.80,0.91)];Esd的SSEN为0.85[95％CI(0.80,0.89)],SSPE为0.90[95％CI(0.85,0.94)].Emax、Emea、Eratio、Esd合并受试者工作特性曲线的曲线下面积分别为0.95、0.93、0.93、0.93.结论 剪切波弹性模量参数有助于鉴别乳腺良恶性肿块,其中Emax的诊断效能最优.