Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma:a meta-analysis  

作　　者：Jie Yang Jiayan Huang Yonggang Zhang Keyu Zeng Min Liao Zhenpeng Jiang Wuyongga Bao Qiang Lu 

机构地区：[1]Department of Ultrasound,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China [2]Laboratory of Ultrasound Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China [3]The Chinese Centre of Evidence-Based Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China

出　　处：《Chinese Medical Journal》2023年第17期2028-2036,共9页中华医学杂志（英文版）

基　　金：Science and Technology Department of Sichuan Province(No.2018FZ0044);National Natural Science Foundation of China(No.81571697)

摘　　要：Background:Patients with mass-forming pancreatitis(MFP)or pancreatic ductal adenocarcinoma(PDAC)presented similar clinical symptoms,but required different treatment approaches and had different survival outcomes.This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT)in differentiating MFP from PDAC.Methods:A literature search was performed in the PubMed,EMBASE(Ovid),Cochrane Library(CENTRAL),China National Knowledge Infrastructure(CNKI),Weipu(VIP),and WanFang databases to identify original studies published from inception to August 20,2021.Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included.The meta-analysis was performed with Stata 15.0 software.The outcomes included the pooled sensitivity,specificity,positive likelihood ratio(+LR),negative likelihood ratio(-LR),diagnostic odds ratio(DOR),and summary receiver operating characteristic(SROC)curves of CEUS and CECT.Meta-regression was conducted to investigate heterogeneity.Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.Results:Twenty-six studies with 2115 pancreatic masses were included.The pooled sensitivity and specificity of CEUS for MFP were 82%(95%confidence interval[CI],73%-88%;I^(2)=0.00%)and 95%(95%CI,90%-97%;I^(2)=63.44%),respectively;the overall+LR,-LR,and DOR values were 15.12(95%CI,7.61-30.01),0.19(95%CI,0.13-0.29),and 78.91(95%CI,30.94-201.27),respectively;and the area under the SROC curve(AUC)was 0.90(95%CI,0.87-92).However,the overall sensitivity and specificity of CECT were 81%(95%CI,75-85%;I^(2)=66.37%)and 94%(95%CI,90-96%;I^(2)=74.87%);the overall+LR,-LR,and DOR values were 12.91(95%CI,7.86-21.20),0.21(95%CI,0.16-0.27),and 62.53(95%CI,34.45-113.51),respectively;and,the SROC AUC was 0.92(95%CI,0.90-0.94).The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC(relative DOR 1.26,95%CI[0.

关 键 词：PANCREATITIS Pancreatic neoplasms ULTRASONOGRAPHY Tomography X-ray computed META-ANALYSIS 

分 类 号：R576[医药卫生—消化系统] R735.9[医药卫生—内科学]