Real-Time Elastography for the Differentiation of Benign and Malignant Thyroid Nodules: A Meta-Analysis
Real-Time Elastography for the Differentiation of Benign and Malignant Thyroid Nodules: A Meta-Analysis
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DOI：
10.1089/thy.2010.0079
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发表时间：
2010-10-01
期刊：
影响因子：
6.6
通讯作者：
Friedrich-Rust, Mireen
中科院分区：
文献类型：
--
作者：
Bojunga, Joerg;Herrmann, Eva;Friedrich-Rust, Mireen
背景：甲状腺结节的后处理仍然具有挑战性。细针穿刺（FNA）已被证明是选择患者进行手术的最具成本效益的方法，检测恶性病变的灵敏度为54%-90%，特异性为60%-96%。基于超声的实时弹性成像（RTE）能够确定组织弹性，并已显示出分化甲状腺结节的有希望的结果。进行荟萃分析，以评估RTE的分化甲状腺nodel.Methods的整体性能：检索文献数据库。研究的纳入标准是使用手术标本的FNA细胞学组织病理学作为诊断参考标准，并评估RTE的敏感性和特异性。荟萃分析采用逆方差法和Der Simonian和Laird随机效应估计的情况下建立heterogeneity.Results：8项研究，包括共639甲状腺结节进行了分析。8项研究中，RTE诊断恶性甲状腺结节的总体平均灵敏度和特异性分别为92%置信区间88-96和90%置信区间85-95。结论：RTE对甲状腺结节的诊断具有较高的敏感性和特异性。这项技术可能是有用的结合，甚至取代FNA选择甲状腺结节的患者进行手术。
Background: Work-up of thyroid nodules remains challenging. Fine-needle aspiration (FNA) has been shown to be the most cost-effective way to select patients for surgery with sensitivities of 54%-90% and specificities of 60%-96% for the detection of malignant lesions. Ultrasound-based real-time elastography (RTE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. A meta-analysis was performed to assess the overall performance of RTE for the differentiation of thyroid nodules.Methods: Literature databases were searched. The inclusion criteria for studies were the use of FNA cytology histopathology of surgical specimens as the diagnostic reference standard and assessment of sensitivity and specificity of RTE. The meta-analysis was performed using an inverse variance method and the Der Simonian and Laird Random effect estimator in case of established heterogeneity.Results: Eight studies that included a total of 639 thyroid nodules were analyzed. The overall mean sensitivity and specificity for the diagnosis of malignant thyroid nodules by RTE of the eight studies was 92% confidence interval 88-96 and 90% confidence interval 85-95, respectively. A significant heterogeneity was found for specificity of the different studies.Conclusions: RTE has a high sensitivity and specificity in the evaluation of thyroid nodules. This technique might be useful in conjunction or even instead of FNA to select patients with thyroid nodules for surgery.