Wu Yin, Zhou Chunmei, Shi Bo, Zeng Zhuohua, Wu Xinyu, Liu Jiakai
Department of Ultrasonic Medicine, The 2nd Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Obstetrics and Gynecology Department, The 2nd Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Gland Surg. 2022 Jun;11(6):1067-1077. doi: 10.21037/gs-22-254.
Conventional ultrasound and contrast-enhanced ultrasound (CEUS) are commonly used in the diagnosis of benign and malignant thyroid nodules. However, the value of the two methods in the diagnosis of benign and malignant thyroid nodules remains controversial.
PubMed, Medline, EBSCO, Science Direct, Cochrane Library, China National Knowledge Infrastructure (CNKI) database and manual journal retrieval were searched from January 2000 to January 2022, to include research on conventional ultrasound or CEUS in the diagnosis of benign and malignant thyroid nodule related clinical studies. Meta-analysis was conducted using RevMan5.3 and Stata Corp to analyze the sensitivity and specificity of conventional ultrasound and CEUS in the diagnosis of benign and malignant thyroid nodules with 95% confidence interval (CI) as indicators. Heterogeneity of the results was evaluated by Q test and I in RevMan5.3. Deek's method was used to evaluate publication bias.
A total of 1,378 nodules were included in 11 literatures, including 535 malignant thyroid nodules and 843 benign thyroid nodules. Heterogeneity tests conducted for CEUS diagnostic sensitivity of the 6 included literatures indicated that there was no heterogeneity among the study groups [Q=2.05, degree of freedom (df) =5.00, I=0.00%, P=0.84]. The combined sensitivity was 0.87, with 95% confidence interval (CI): 0.82 to 0.90. Heterogeneity tests on the diagnostic specificity of CEUS of the six included literatures suggested that there was heterogeneity among the different study groups (Q=14.27, df =5.00, I=64.96%, P=0.01). The combined specificity was 0.84 (95% CI: 0.78 to 0.89). Heterogeneity tests performed on the sensitivity of five conventional ultrasound diagnosis articles revealed that there was heterogeneity among different study groups (Q=13.62, df =4.00, I=70.64%, P=0.01). The combined sensitivity was 0.86 (95% CI: 0.78 to 0.92). Heterogeneity tests on the specificity of conventional ultrasound diagnosis in five included literatures indicated that there was heterogeneity among different study groups (Q=16.94, df =4.00, I=76.39%, P=0.00). The combined specificity was 0.84 (95% CI: 0.75 to 0.90). There was no bias in the included literature.
The sensitivity of CEUS in the diagnosis of benign and malignant thyroid nodules was slightly higher than that of conventional ultrasound, which provides a reference for the clinical diagnosis of benign and malignant thyroid nodules.
传统超声和超声造影（CEUS）常用于诊断甲状腺良恶性结节。然而，这两种方法在甲状腺良恶性结节诊断中的价值仍存在争议。
检索2000年1月至2022年1月期间的PubMed、Medline、EBSCO、Science Direct、Cochrane图书馆、中国知网（CNKI）数据库，并进行手工期刊检索，纳入有关传统超声或CEUS诊断甲状腺良恶性结节的相关临床研究。使用RevMan5.3和Stata Corp进行荟萃分析，以95%置信区间（CI）为指标分析传统超声和CEUS诊断甲状腺良恶性结节的敏感性和特异性。在RevMan5.3中通过Q检验和I²评估结果的异质性。采用Deek法评估发表偏倚。
11篇文献共纳入1378个结节，其中甲状腺恶性结节535个，良性甲状腺结节843个。对纳入的6篇文献进行CEUS诊断敏感性的异质性检验表明，各研究组间无异质性[Q=2.05，自由度（df）=5.00，I²=0.00%，P=0.84]。合并敏感性为0.87，95%置信区间（CI）：0.82至0.90。对纳入的6篇文献进行CEUS诊断特异性的异质性检验表明，不同研究组间存在异质性（Q=14.27，df =5.00，I²=64.96%，P=0.01）。合并特异性为0.84（95%CI：0.78至0.89）。对5篇传统超声诊断文章的敏感性进行异质性检验显示，不同研究组间存在异质性（Q=13.62，df =4.00，I²=70.64%，P=0.01）。合并敏感性为0.86（95%CI：0.78至0.92）。对纳入的5篇文献进行传统超声诊断特异性的异质性检验表明，不同研究组间存在异质性（Q=16.94，df =4.00，I²=76.39%，P=0.00）。合并特异性为0.84（95%CI：0.75至0.90）。纳入文献无偏倚。
CEUS诊断甲状腺良恶性结节的敏感性略高于传统超声，为甲状腺良恶性结节的临床诊断提供了参考。
