Real-time Ultrasound Elastography for Differentiation of Benign and Malignant Thyroid Nodules A Meta-analysis
Real-time Ultrasound Elastography for Differentiation of Benign and Malignant Thyroid Nodules A Meta-analysis
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DOI：
10.7863/ultra.33.3.495
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发表时间：
2014-03-01
影响因子：
2.3
通讯作者：
Wang, Xuemei
中科院分区：
文献类型：
--
作者：
Sun, Jiasi;Cai, Jingyu;Wang, Xuemei
目的-当今治疗甲状腺结节的临床挑战是诊断少数恶性疾病。实时超声弹性成像可以测量组织弹性，作为传统超声检查的补充，可改善甲状腺肿瘤的诊断。评估弹性图有两个常见标准：弹性得分和应变比。进行这项荟萃分析是为了扩展之前的荟萃分析，以评估超声弹性成像在弹性评分和应变比评估方面区分良性和恶性甲状腺结节的诊断能力。方法检索截至 2013 年 1 月 31 日的 MEDLINE、EMBASE、PubMed 和 Cochrane 图书馆数据库。汇总的敏感性、特异性和汇总受试者工作特征曲线是通过随机效应模型的个别研究获得的。探讨异质性的程度和来源。结果共分析了4468例患者的5481个结节进行弹性评分研究和983例患者的1063个结节进行应变比研究。超声弹性成像诊断甲状腺结节的总体平均敏感性和特异性分别为 0.79（95% CI，0.77-0.81）和 0.77（95% CI，0.76-0.79），弹性评分评估分别为 0.85（95% CI，0.81-0.89）和 0.80（95% CI，0.76-0.79）。 0.77-0.83）分别用于应变比评估。弹性得分和应变比的曲线下面积分别为 0.8941 和 0.9285。 结论 这些结果证实了先前荟萃分析中获得的结果。超声弹性成像对于甲状腺结节的识别具有较高的敏感性和特异性。它是减少不必要的细针抽吸活检的有前途的工具。
Objectives-The clinical challenge of managing thyroid nodules nowadays is to diagnose the minority of malignant disease. Real-time ultrasound elastography, which can measure tissue elasticity, is used as a complement to conventional sonography for improving the diagnosis of thyroid tumors. There are 2 common criteria for evaluating an elastogram: the elasticity score and strain ratio. This meta-analysis was performed to expand on a previous meta-analysis to assess the diagnostic power of ultrasound elastography in differentiating benign and malignant thyroid nodules for elasticity score and strain ratio assessment.Methods The MEDLINE,, EMBASE, PubMed, and Cochrane Library databases up to January 31, 2013, were searched. The pooled sensitivity, specificity, and summary receiver operating characteristic curve were obtained from individual studies with a random-effects model. The extent and sources of heterogeneity were explored.Results A total of 5481 nodules in 4468 patients for elasticity score studies and 1063 nodules in 983 patients for strain ratio studies were analyzed. The overall mean sensitivity and specificity of ultrasound elastography for differentiation of thyroid nodules were 0.79 (95% confidence interval [CI], 0.77-0.81) and 0.77 (95% CI, 0.76-0.79) for elasticity score assessment and 0.85 (95% CI, 0.81-0.89) and 0.80 (95% CI, 0.77-0.83) for strain ratio assessment, respectively. The areas under the curve for the elasticity score and strain ratio were 0.8941 and 0.9285.Conclusions These results confirmed those obtained in the previous meta-analysis. Ultrasound elastography has high sensitivity and specificity for identification of thyroid nodules. It is a promising tool for reducing unnecessary fine-needle-aspiration biopsy.