Lu Yi, Chen Lu, Li Chujun, Chen Honglei, Chen Jinhua
Digestive Endoscopy Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou.
Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Med Ultrason. 2017 Apr 22;19(2):150-158. doi: 10.11152/mu-987.
The accuracy for endoscopic ultrasonography-elastography (EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA).Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95%CI, 0.95-0.99) and 0.67 (95%CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95%CI, 0.95-0.98) and 0.67(95%CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95%CI, 0.96-0.99) and 0.62 (95%CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95%CI, 0.83-0.95) and 0.76 (95%CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95%CI, 0.77-0.90) and 0.96(95%CI, 0.88-1.00), respectively.
EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.
内镜超声弹性成像（EUS-EG）评估胰腺实性肿块的准确性差异很大，且自2013年以来汇总结果未更新。此外，EUS-EG、对比增强内镜超声（CE-EUS）和EUS引导下细针穿刺活检（EUS-FNA）之间仍缺乏全面比较。
全面检索关于EUS-EG在胰腺实性肿块中作用的诊断性试验。使用Meta-Disc计算汇总敏感性、特异性、诊断比值比和总结接收器操作特征。
最终纳入17项研究（1537例患者，1544个病灶）。定性方法的汇总敏感性和特异性分别为0.97（95%CI，0.95-0.99）和0.67（95%CI，0.59-0.74）；应变直方图的汇总敏感性和特异性分别为0.97（95%CI，0.95-0.98）和0.67（95%CI，0.61-0.73）；应变比的汇总敏感性和特异性分别为0.98（95%CI，0.96-0.99）和0.62（95%CI，0.56-0.68）；CE-EUS的汇总敏感性和特异性分别为0.90（95%CI，0.83-0.95）和0.76（95%CI，0.67-0.84）；EUS-FNA的汇总敏感性和特异性分别为0.84（95%CI，0.77-0.90）和0.96（95%CI，0.88-1.00）。
EUS-EG在鉴别胰腺实性肿块方面可靠；不同诊断方法的敏感性和特异性非常接近。EUS-EG和CE-EUS均可作为EUS-FNA的有价值的补充手段。
