实时剪切波弹性成像联合超声BI-RADS诊断乳腺癌的Meta分析  

Value of quantitative shear wave elastography combined with greyscale ultrasound according to BI-RADS classification:A Meta-analysis.

作　　者：何玉霜[1] 彭玉兰[1] 金亚[2] 赵海娜[1] 杨盼[1] 

机构地区：[1]四川大学华西医院超声科,四川成都610041 [2]四川大学华西第二医院超声科,四川成都610041

出　　处：《西部医学》2016年第4期505-510,共6页Medical Journal of West China

基　　金：国家自然科学基金(81571694)

摘　　要：目的评估实时剪切波弹性成像定量参数对乳腺癌的诊断效能,确定特异度和敏感度最优的定量参数。方法检索实时剪切波弹性成像联合超声BI-RADS评估方法定量诊断乳腺肿瘤良恶性的相关文献,提取纳入文献的特征信息进行Meta分析,汇总敏感度、特异度、阳性似然比、阴性似然比和诊断优势比,绘制受试者工作特征曲线,并计算曲线下面积。另外根据文献选择的定量参数不同(Emax、Emean、Eratio、Emin及SD)进行亚组分析。结果纳入文献23篇,实时剪切波弹性成像定量指标诊断乳腺肿瘤汇总敏感度0.90,特异度0.87,曲线下面积0.95,阳性似然比6.9,阴性似然比为0.11,诊断优势比61。亚组分析结果为Emax诊断敏感度0.92,特异度0.89,诊断优势比87;SD诊断敏感度0.85,特异度0.92,诊断优势比68。纳入文献无发表偏倚(P=0.48>0.05)。结论实时剪切波弹性成像杨氏模量联合超声BI-RADS鉴别诊断乳腺肿瘤具有较高的准确性;选择定量参数SD可提高诊断特异度,Emax可提高敏感度及准确性。Objective To evaluate the value of shear-wave elastography Young＇s modulus in the diagnosis of solid breast masses and to provide the basis for accurate selection of relevant quantitative parameters.Methods We searched the databases for the assays about the quantitative shear-wave elastography combined with ultrasound to BI-RADS classification in the diagnosis of solid breast masses and extracted the characteristics of the included studies to perform a metaanalysis.Sensitivity,specificity,positive likelihood ratio（PLR）,negative likelihood ratio（NLR）,diagnostic odds ratio（DOR）and their 95%C I were calculated,and SROC curve was drawn.According to the different quantitative parameters selected by the included studies,we performed the subgroup analysis.Results 23 studies were included,and the sensitivity,specificity,area under the curve,PLR,NLR and the diagnostic odds ratio of quantitative parameters of shear-wave elastography in the differential diagnosis of solid breast masses were 0.90,0.87,0.95,6.9,0.11 and 61,respectively.The included studies were of no publication bias.Conclusion Quantitative shear wave elastography combined with greyscale ultrasound according to BI-RADS classification owns high diagnostic accuracy in the diagnosis of solid breast masses.The specificity could be raised choosing SD;sensitivity and accuracy could be raised choosing Emax.

关 键 词：实时剪切波弹性成像 超声BI-RADS 乳腺癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]