Behzadmehr Razieh, Salarzaei Morteza
Associate Professor of Radiology, Zabol University of Medical Sciences, Zabol, Iran.
Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran.
J Med Imaging Radiat Sci. 2021 Mar;52(1):127-136. doi: 10.1016/j.jmir.2020.09.014. Epub 2020 Oct 29.
Gallbladder adenoma (GA) is a precancerous neoplasm and needs surgical resection. It is difficult to differentiate adenoma from other gallbladder polyps using imaging examinations. The aim of present systematic review and meta-analysis was to evaluate the diagnostic accuracy of contrast-enhanced ultrasound in the diagnosis of gallbladder adenoma.
The searches were conducted by two independent researchers to find the relevant studies published from 1/1/2009 until end of 30/06/2019. The search included published literature in the English language in MEDLINE via PubMed, EMBASE via Ovid, The Cochrane Library, and Trip databases. For literature published in other languages, national databases (Magiran and SID), KoreaMed, and LILACS were searched. The risk of bias of every article was evaluated by using QUADAS-2. On the basis of the results from the 2 × 2 tables, pooled measures for sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curves (AUC) along with their 95% confidence intervals (CIs) were calculated using the DerSimonian Lair methodology.
Overall, 868 patients were studied in the 10 studies chosen for inclusion. Of these 10 studies, 5 (50%) were retrospective and 5 (50%) were prospective. The total prevalence of gallbladder adenoma in 10 studies was 16% (95% CI 13%, 18%). The sensitivity and specificity of contrast-enhanced ultrasound were 0.846 (95% CI 0.818-0.871) and 0.870 (95% CI: 0.844-0.894), respectively. The diagnostic odds ratio was 40.807 (95% CI 18.838-88.393).
CEUS is a reliable, non-invasive, and no-radiation-exposure imaging modality with a high sensitivity and specificity for detection of gallbladder adenoma. Nonetheless, it should be applied cautiously, and large scale, well-designed trials are necessary to assess its clinical value.
胆囊腺瘤（GA）是一种癌前肿瘤，需要手术切除。利用影像学检查很难将腺瘤与其他胆囊息肉区分开来。本系统评价和荟萃分析的目的是评估超声造影在胆囊腺瘤诊断中的诊断准确性。
由两名独立研究人员进行检索，以查找2009年1月1日至2019年6月30日期间发表的相关研究。检索范围包括通过PubMed在MEDLINE、通过Ovid在EMBASE、Cochrane图书馆和Trip数据库中发表的英文文献。对于其他语言发表的文献，检索了国家数据库（Magiran和SID）、韩国医学数据库和拉丁美洲及加勒比地区卫生科学数据库。使用QUADAS-2评估每篇文章的偏倚风险。根据2×2表格的结果，采用DerSimonian Lair方法计算合并敏感度、特异度、诊断比值比（DOR）和曲线下面积（AUC）及其95%置信区间（CI）。
总体而言，入选的10项研究共纳入868例患者。在这10项研究中，5项（50%）为回顾性研究，5项（50%）为前瞻性研究。10项研究中胆囊腺瘤的总患病率为16%（95%CI 13%，18%）。超声造影的敏感度和特异度分别为0.846（95%CI 0.818 - 0.871）和0.870（95%CI：0.844 - 0.894）。诊断比值比为40.807（95%CI 18.838 - 88.393）。
超声造影是一种可靠、无创且无辐射暴露的成像方式，对胆囊腺瘤的检测具有较高的敏感度和特异度。尽管如此，仍应谨慎应用，需要大规模、设计良好的试验来评估其临床价值。
