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超声、计算机断层扫描、磁共振成像、正电子发射断层扫描/计算机断层扫描和实时弹性成像在鉴别涎腺良恶性肿瘤中的诊断作用:荟萃分析。

The diagnostic role of ultrasonography, computed tomography, magnetic resonance imaging, positron emission tomography/computed tomography, and real-time elastography in the differentiation of benign and malignant salivary gland tumors: a meta-analysis.

机构信息

Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.

Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Oct;128(4):431-443.e1. doi: 10.1016/j.oooo.2019.06.014. Epub 2019 Jun 27.

Abstract

OBJECTIVE

The objective of this study was to assess the diagnostic properties of ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography/computed tomography (PET/CT), and real-time elastography (RTE) in distinguishing between benign and malignant salivary gland tumors.

STUDY DESIGN

English databases were searched for eligible studies. Diagnostic accuracy parameters, including sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves (SROC) were calculated. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity.

RESULTS

In total, 38 studies were included. Pooled sensitivities for ultrasonography, CT, MRI, PET/CT, and RTE were 0.66, 0.70, 0.80, 0.81, and 0.80, respectively. Pooled specificities were 0.92, 0.73, 0.90, 0.89, and 0.70, respectively. The DORs were 23, 6, 38, 20, and 10, respectively. The areas under the curve (AUC) of SROC for US, CT, MRI, PET/CT, and RTE were 0.91, 0.77, 0.92, 0.88, and 0.82, respectively.

CONCLUSION

Based on the results of the meta-analysis, MRI may be the first choice for the differential diagnosis of benign and malignant salivary gland tumors for its relatively high diagnostic value. PET/CT tends to have greater accuracy than CT. Ultrasonography and RTE may help achieve better diagnostic outcomes if they are used in conjunction.

摘要

目的

本研究旨在评估超声、计算机断层扫描(CT)、磁共振成像(MRI)、正电子发射断层扫描/计算机断层扫描(PET/CT)和实时弹性成像(RTE)在鉴别良恶性涎腺肿瘤方面的诊断性能。

研究设计

检索英文数据库以确定符合条件的研究。计算了诊断准确性参数,包括敏感性、特异性、诊断比值比(DOR)和汇总受试者工作特征曲线(SROC)。进行了元回归和亚组分析以确定异质性的来源。

结果

共纳入 38 项研究。超声、CT、MRI、PET/CT 和 RTE 的汇总敏感性分别为 0.66、0.70、0.80、0.81 和 0.80。汇总特异性分别为 0.92、0.73、0.90、0.89 和 0.70。DOR 分别为 23、6、38、20 和 10。SROC 的曲线下面积(AUC)分别为 0.91、0.77、0.92、0.88 和 0.82。

结论

基于荟萃分析的结果,MRI 可能是鉴别良恶性涎腺肿瘤的首选方法,因为其具有较高的诊断价值。与 CT 相比,PET/CT 具有更高的准确性。如果联合使用,超声和 RTE 可能有助于获得更好的诊断结果。

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