超声弹性成像对甲状腺结节良恶性诊断价值的Meta分析  

Diagnostic value of ultrasonic elastography in benign and malignant thyroid nodules：a Meta-analysis

作　　者：张文翠[1] 高晓丽[1] 曹建滨[1] 门璐[1] 刘辉[1] 周海波[2] 

机构地区：[1]黑龙江省哈尔滨市疾病预防控制中心地方病预防控制所,150056 [2]哈尔滨医科大学公共卫生学院流行病教研室

出　　处：《中华地方病学杂志》2014年第4期437-441,共5页Chinese Journal of Endemiology

摘　　要：目的：采用Meta分析方法评价超声弹性成像对甲状腺结节良恶性诊断的价值。方法计算机检索中国知网（CNKI）、万方数据库，收集所有使用超声弹性成像对甲状腺结节良恶性进行诊断的文献，根据Cochrane协作网与诊断试验方法组推荐的诊断试验纳入标准筛选文献，提取纳入研究的特征信息。采用新修订的诊断性试验准确性质量评价工具QUADAS-2对纳入的文献进行质量评价；Meta-DiSc 1.4软件进行Meta分析，并绘制受试者工作特征曲线（SROC）。结果根据检索词初步检索出文献231篇，经筛选最终纳入16篇，其中5篇文献质量评价为A级，8篇为B级，3篇为C级。16篇文献中包含甲状腺结节患者1325例，结节病灶1641个。合并诊断灵敏度和特异度分别为0.87[95%可信区间（CI）为0.84-0.89]、0.84（95%CI为0.82-0.86），合并阳性和阴性似然比分别为5.85（95%CI为4.47-7.65）、0.17（95%CI为0.13-0.21），SROC曲线下面积为0.93，标准误（SE）=0.01。结论超声弹性成像对甲状腺结节良恶性具有较高临床诊断价值。Objective To evaluate the diagnostic value of ultrasonic elastography （UE） in benign and malignant thyroid nodules by Meta analysis. Methods Computer was used to search China national knowledge infrastructure（CNKI）, Wanfang database, and relevant Chinese articles about UE in assessing diagnostic accuracy of benign and malignant thyroid nodules were collected. According to the diagnostic test criteria recommended by Cochrane Screening and Diagnostic Test Group, the literatures were screened and feature information was included in the study. The quality evaluation tool of diagnostic test accuracy（QUADAS-2） was used to assess the quality of the literatures; Meta analysis was performed with Meta-DiSc 1.4 software, and receiver operating characteristic curve（SROC） was drawn. Results According to the key words, two hundred and thirty-one articles were retrieved initially, and finally 16 articles were included after screening; the quality of five articles was grade A; eight was grade B; and three was grade C. Sixteen articles contained 1 325 patients with 1 641 thyroid nodules. The pooled sensitivity and specificity were 0.87 [95%confidence interval （CI）： 0.84 - 0.89] and 0.84 （95%CI： 0.82 - 0.86）, respectively; the pooled positive and negative likelihood ratios were 5.85 （95%CI：4.47-7.65） and 0.17（95%CI：0.13 - 0.21）, respectively; the area under the curve of SROC was 0.93, standard error（SE） =0.01. Conclusion The results of meta-analysis suggest that UE has high value in the diagnosis of benign and malignant thyroid nodules.

关 键 词：超声弹性成像 甲状腺结节 诊断 

分 类 号：R581[医药卫生—内分泌]