Liu Ying, Li Jia, Tan Yi-ran, Xiong Ping, Zhong Lai-ping
Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai, China.
Department of Ultrasound, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Feb;119(2):238-245.e2. doi: 10.1016/j.oooo.2014.10.020. Epub 2014 Nov 14.
To compare ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) for clinical differential diagnosis in patients with salivary gland tumor (SGT).
Six databases were used to search the literature published between 1982 and 2013. Histologic diagnosis was required as standard diagnosis. Pooled estimate for sensitivity, specificity, summary receiver-operating characteristic curve (SROC) and area under curve (AUC) were calculated and compared using STATA and Meta-Disc statistical software.
Nineteen articles were included. Pooled sensitivity for US, CT, and MRI was 0.629 (95% confidence interval [CI] 0.52-0.73), 0.830 (95% CI 0.74-0.90), and 0.807 (95% CI 0.73-0.87), respectively; pooled specificity for US, CT, and MRI was 0.920 (95% CI 0.89-0.94), 0.851 (95% CI 0.79-0.90), and 0.886 (95% CI 0.85-0.92), respectively. The AUC under SROC for US, CT, and MRI was 0.934 ± 0.058, 0.912 ± 0.889, and 0.903 ± 0.045, respectively.
CT is recommended, as it is an effective imaging tool for differential diagnosis in patients with primary SGT, and MRI is suggested for differential diagnosis between benign and malignant GSTs because of its highest sensitivity and specificity.
比较超声检查(US)、计算机断层扫描(CT)和磁共振成像(MRI)在涎腺肿瘤(SGT)患者临床鉴别诊断中的应用。
使用六个数据库检索1982年至2013年发表的文献。组织学诊断作为标准诊断。使用STATA和Meta-Disc统计软件计算并比较敏感性、特异性、汇总受试者工作特征曲线(SROC)和曲线下面积(AUC)的合并估计值。
纳入19篇文章。US、CT和MRI的合并敏感性分别为0.629(95%置信区间[CI]0.52 - 0.73)、0.830(95%CI 0.74 - 0.90)和0.807(95%CI 0.73 - 0.87);US、CT和MRI的合并特异性分别为0.920(95%CI 0.89 - 0.94)、0.851(95%CI 0.79 - 0.90)和0.886(95%CI 0.85 - 0.92)。US、CT和MRI的SROC下的AUC分别为0.934±0.058、0.912±0.889和0.903±0.045。
推荐使用CT,因为它是原发性SGT患者鉴别诊断的有效成像工具;由于MRI具有最高的敏感性和特异性,建议用于鉴别良性和恶性涎腺肿瘤。