比较剪切波弹性成像和应变弹性成像诊断乳腺肿瘤的准确性：系统评价和荟萃分析。

Comparing the accuracy of shear wave elastography and strain elastography in the diagnosis of breast tumors: A systematic review and meta-analysis.

机构信息

The First Affiliated Hospital of Dalian Medical University, Dalian, China.

Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Medicine (Baltimore). 2022 Nov 4;101(44):e31526. doi: 10.1097/MD.0000000000031526.

BACKGROUND

Shear wave elastography (SWE) and strain elastography (SE) are 2 new ultrasonic technologies which have developed rapidly in recent years. Elastography transforms the elastic information of tissue into optical information for display, thus more intuitive display of tissue elasticity. Conflicting results have been obtained in different scholars' studies on the accuracy comparison of the 2 elastography technologies in the diagnosis of breast tumors. This meta-analysis aims to compare the accuracy of the 2 elastography technologies in the diagnosis of breast tumors, and provide a reference for clinical decision making.

METHODS

We have searched Chinese and English literatures on the accuracy of SWE and SE in the diagnosis of breast tumors from PubMed, Web of Science, China national knowledge infrastructure and Wanfang databases, and the time was up to December30, 2020. Two literature reviewers screened the literatures according to the screening criteria, and Quality Assessment of Diagnostic Accuracy Study tool was used to evaluate the quality of included literatures. Meta Disc1.4 and Stata14.0 softwares were used to perform heterogeneity test, sensitivity analysis and publication bias test.

RESULTS

Ten literatures included 1599 patients and 1709 breast lesions. The final results in the SWE as follow: The pooled sensitivity was 0.852 (95% confidence interval [CI] [0.826-0.874]), the pooled specificity (Spe) was 0.799 (95% CI [0.776-0.820]), the pooled positive likelihood ratio was 4.758 (95% CI [3.443-6.576]), the pooled negative likelihood ratio was 0.192 (95% CI [0.147-0.250]), the pooled diagnostic odds ratio was 29.071 (95% CI [16.967-49.811]), and the area under the summary receiver operating characteristic curve was 0.9159. The final results in the SE as follow: The pooled sensitivity was 0.843 (95% CI [0.817-0.866]), the pooled Spe was 0.766 (95% CI [0.743-0.789]), the pooled positive likelihood ratio was 4.387 (95% CI [3.088-6.233]), the pooled negative likelihood ratio was 0.216 (95% CI [0.179-0.261]), the pooled diagnostic odds ratio was 22.610 (95% CI [15.622-32.724]), and the area under the summary receiver operating characteristic curve was 0.8987.

CONCLUSION

The sensitivity and Spe of SWE were higher than those of SE, suggesting that SWE may have a higher accuracy in the diagnosis of breast tumors.

REGISTER NAME

PROSPERO. Registration number: CRD42021251110.

背景

剪切波弹性成像（SWE）和应变成像（SE）是近年来迅速发展起来的两种新的超声技术。弹性成像是将组织的弹性信息转化为光学信息进行显示，从而更直观地显示组织的弹性。不同学者对这两种弹性成像技术在诊断乳腺肿瘤中的准确性比较研究结果存在差异。本荟萃分析旨在比较两种弹性成像技术在诊断乳腺肿瘤中的准确性，为临床决策提供参考。

方法

我们检索了 PubMed、Web of Science、中国知网和万方数据库中关于 SWE 和 SE 诊断乳腺肿瘤准确性的中英文文献，检索时间截至 2020 年 12 月 30 日。两名文献综述员根据筛选标准筛选文献，并使用诊断准确性研究质量评估工具评估纳入文献的质量。使用 Meta Disc1.4 和 Stata14.0 软件进行异质性检验、敏感性分析和发表偏倚检验。

结果

纳入了 10 项研究，共 1599 名患者和 1709 个乳腺病灶。SWE 的最终结果如下：合并敏感性为 0.852（95%置信区间[CI] [0.826-0.874]），合并特异性（Spe）为 0.799（95% CI [0.776-0.820]），合并阳性似然比为 4.758（95% CI [3.443-6.576]），合并阴性似然比为 0.192（95% CI [0.147-0.250]），合并诊断比值比为 29.071（95% CI [16.967-49.811]），汇总受试者工作特征曲线下面积为 0.9159。SE 的最终结果如下：合并敏感性为 0.843（95% CI [0.817-0.866]），合并 Spe 为 0.766（95% CI [0.743-0.789]），合并阳性似然比为 4.387（95% CI [3.088-6.233]），合并阴性似然比为 0.216（95% CI [0.179-0.261]），合并诊断比值比为 22.610（95% CI [15.622-32.724]），汇总受试者工作特征曲线下面积为 0.8987。