Ultrasonic, Tianjin Baodi Hospital, China.
Tianjin Baodi Hospital.
Rev Esp Enferm Dig. 2019 May;111(5):388-396. doi: 10.17235/reed.2018.5818/2018.
contrast-enhanced ultrasound (CEUS) is increasingly used to identify vascular complications in patients after liver transplantation. The present study aimed to evaluate the diagnostic accuracy of CEUS using all available data.
relevant studies published before February 2018 were retrieved from PubMed, EMBASE, ScienceDirect and Web of Science. Pooled sensitivity and specificity, diagnostic odds ratio (DOR) and summary receiver operating characteristic curve (SROC) were calculated to estimate the diagnostic performance of CEUS for vascular complications. Sensitivity analysis was performed that stratified studies according to age, study design and sample size in order to determine the influence of these factors on the overall effect. Meta-regression analyses were performed to examine the possible sources of heterogeneity. Quality assessment and publication bias of the included studies were also evaluated.
thirteen studies which consisted of 2,781 CEUS cases were included in the analysis. The pooled weighted estimates of sensitivity and specificity were 0.90 (95% CI, 0.84 to 0.95) and 1.00 (95% CI, 1.00 to 1.00), the diagnostic odds ratio (DOR) was 431.96 (95% CI, 164.60 to 1,133.59) and the area under the curve (AUC) of SROC was 0.9741. According to the sensitivity analysis, age, study design and sample size had an insignificant influence on the diagnostic performance of CEUS. The meta-regression analyses did not reveal a strong correlation between CEUS accuracy and study design, treatment time of patients and experience of the radiologists.
the results of our meta-analysis showed a high sensitivity, specificity and accuracy of the CEUS modality for the identification of vascular complications in patients after liver transplantation. Since this is the first meta-analysis investigating in this aspect, more evidence is required to validate the clinical utility of CEUS for the identification of vascular complications in patients with a transplanted liver.
对比增强超声（CEUS）越来越多地用于诊断肝移植术后患者的血管并发症。本研究旨在利用所有可用数据评估 CEUS 的诊断准确性。
从 PubMed、EMBASE、ScienceDirect 和 Web of Science 检索到 2018 年 2 月之前发表的相关研究。计算合并的敏感性和特异性、诊断比值比（DOR）和汇总受试者工作特征曲线（SROC），以评估 CEUS 对血管并发症的诊断性能。进行了敏感性分析，根据年龄、研究设计和样本量对研究进行分层，以确定这些因素对总效应的影响。进行了荟萃回归分析，以检查可能的异质性来源。还评估了纳入研究的质量评估和发表偏倚。
纳入了 13 项研究，共包括 2781 例 CEUS 病例。合并的敏感性和特异性加权估计值分别为 0.90（95%CI，0.84 至 0.95）和 1.00（95%CI，1.00 至 1.00），诊断比值比（DOR）为 431.96（95%CI，164.60 至 1133.59），SROC 的曲线下面积（AUC）为 0.9741。根据敏感性分析，年龄、研究设计和样本量对 CEUS 的诊断性能没有显著影响。荟萃回归分析未显示 CEUS 准确性与研究设计、患者治疗时间和放射科医生经验之间存在强烈相关性。
本荟萃分析结果表明，CEUS 模式在识别肝移植术后患者的血管并发症方面具有较高的敏感性、特异性和准确性。由于这是首次对此方面进行的荟萃分析，因此需要更多证据来验证 CEUS 在识别移植肝患者血管并发症方面的临床应用价值。
