Xue Yan, Yao Shuxin, Li Xiaodong, Zhang Huarong
Department of Ultrasonography, Linyi People's Hospital, Linyi City, Shandong Department of Ultrasonography, Heze Municipal Hospital, Heze City, Shandong Department of Radiology, Linyi People's Hospital, Linyi City, Shandong, China.
Medicine (Baltimore). 2017 Oct;96(42):e7412. doi: 10.1097/MD.0000000000007412.
The analysis was aimed to evaluate the diagnostic accuracy of shear wave elastography (SWE) for malignant breast lesions through a meta-analysis.Related articles were searched from Pubmed, Embase, and Cochrane library. Overall sensitivity and specificity were analyzed with DerSimonian and Laird random effects model. Area under curve with corresponding 95% confidence interval (were calculated to evaluate the diagnostic accuracy of SWE. Sensitivity and publication bias were assessed as well.A total of 25 articles including 4128 patients and 4546 breast lesions were included in the pooled analysis. In the subgroup analysis, diagnostic sensitivity and specificity of SWE in Asian population were 0.84 (0.79-0.88) and 0.87 (0.84-0.90), respectively, whereas they were 0.92 (0.86-0.96) and 0.89 (0.84-0.92) in Caucasian population. The diagnostic accuracy of SWE was a little higher for Caucasians than for Asians (0.95 vs. 0.92). The diagnostic sensitivity and specificity of virtual touch tissue quantification were 0.85 (0.77-0.91) and 0.93 (0.88-0.96), respectively. It showed a little higher value in specificity and summary ROC curve than SWE (0.93 vs. 0.87; 0.95 vs. 0.93). In addition, maximum stiffness exhibited higher detection sensitivity than that of mean stiffness (0.91 vs. 0.85).SWE serves as an accurate diagnostic technology for discriminating between malignant and benign breast lesions.
本分析旨在通过荟萃分析评估剪切波弹性成像(SWE)对乳腺恶性病变的诊断准确性。从PubMed、Embase和Cochrane图书馆检索相关文章。采用DerSimonian和Laird随机效应模型分析总体敏感性和特异性。计算曲线下面积及相应的95%置信区间,以评估SWE的诊断准确性。同时评估敏感性和发表偏倚。共有25篇文章纳入汇总分析,涉及4128例患者和4546个乳腺病变。在亚组分析中,SWE在亚洲人群中的诊断敏感性和特异性分别为0.84(0.79 - 0.88)和0.87(0.84 - 0.90),而在白种人群中分别为0.92(0.86 - 0.96)和0.89(0.84 - 0.92)。SWE对白种人的诊断准确性略高于亚洲人(0.95对0.92)。虚拟触诊组织定量的诊断敏感性和特异性分别为0.85(0.77 - 0.91)和0.93(0.88 - 0.96)。其特异性和汇总ROC曲线值略高于SWE(0.93对0.87;0.95对0.93)。此外,最大硬度的检测敏感性高于平均硬度(0.91对0.85)。SWE是鉴别乳腺良恶性病变的一种准确诊断技术。