Qiu Yuxuan, Xing Zhichao, Yang Qianru, Luo Yan
Department of Ultrasound, Sichuan University West China Hospital, Chengdu, China.
Center of Thyroid & Parathyroid Surgery, Sichuan University West China Hospital, Chengdu, China.
Ultrasonography. 2022 Apr;41(2):279-290. doi: 10.14366/usg.21107. Epub 2021 Jul 31.
This study aimed to assess the diagnostic performance of supersonic impulse (SSI) elastography in differentiating malignant and benign cervical lymph nodes.
The Medline, Embase, and Cochrane Central databases were searched until December 1, 2020. Two different reviewers checked the studies and extracted the data. The diagnostic yields were quantitatively synthesized using a Bayesian bivariate model with an integrated nested Laplace approximation in R.
In total, 590 patients with 892 cervical lymph nodes who underwent SSI elastography were included. The total prevalence of malignancy was 33.7% (301/892), and the four elastic modulus values (mean, maximum, minimum, and standard deviation) were significantly different between malignant and benign lymph nodes. For the mean elastic modulus, the summary estimates for sensitivity and specificity were 0.720 (95% credible interval [CrI], 0.592 to 0.824) and 0.877 (95% CrI, 0.727 to 0.969), respectively. The estimated area under the curve (AUC) was 0.845 (95% CrI, 0.672 to 0.914). For the maximum elastic modulus, the sensitivity and specificity were estimated to be 0.809 (95% CrI, 0.698 to 0.899) and 0.816 (95% CrI, 0.643 to 0.924), respectively. The estimated AUC was 0.834 (95% CrI, 0.579 to 0.938). The minimum and standard deviation of the elastic modulus and the outcomes of the positive and negative likelihood ratio, diagnostic odds ratio, and risk difference were also calculated.
SSI elastography is an acceptable imaging technique for diagnosing malignant cervical lymph nodes, and it can play a complementary role today. Both maximum and mean elastic modulus values should be taken into consideration to make a clinical judgment.
本研究旨在评估超声弹性成像（SSI）在鉴别颈部恶性和良性淋巴结中的诊断性能。
检索Medline、Embase和Cochrane Central数据库至2020年12月1日。两名不同的审阅者检查研究并提取数据。使用R语言中的具有集成嵌套拉普拉斯近似的贝叶斯双变量模型对诊断结果进行定量合成。
总共纳入了590例接受SSI弹性成像检查的892个颈部淋巴结患者。恶性肿瘤的总患病率为33.7%（301/892），恶性和良性淋巴结之间的四个弹性模量值（平均值、最大值、最小值和标准差）存在显著差异。对于平均弹性模量，敏感性和特异性的汇总估计分别为0.720（95%可信区间[CrI]，0.592至0.824）和0.877（95%CrI，0.727至0.969）。估计的曲线下面积（AUC）为0.845（95%CrI，0.672至0.914）。对于最大弹性模量，敏感性和特异性估计分别为0.809（95%CrI，0.698至0.899）和0.816（95%CrI，0.643至0.924）。估计的AUC为0.834（95%CrI，0.579至0.938）。还计算了弹性模量的最小值和标准差以及阳性和阴性似然比、诊断比值比和风险差异的结果。
SSI弹性成像是诊断颈部恶性淋巴结的一种可接受的成像技术，目前它可以发挥辅助作用。在进行临床判断时应同时考虑最大和平均弹性模量值。
