确定儿童和青少年膀胱输尿管反流的最佳对比增强排尿超声检查技术：一项系统评价和网状荟萃分析。
Determining the optimal contrast-enhanced voiding urosonography technique for vesicoureteral reflux in children and adolescents: a systematic review and network meta-analysis.
作者信息
Hu Sha, Tian Yu, He Min
机构信息
Department of Ultrasound, West China Second University Hospital, Sichuan University/Key Laboratory of Obstetrics & Gynecology, Pediatric Diseases, and Birth Defects of the Ministry of Education, Chengdu, China.
出版信息
Front Pediatr. 2025 Apr 25;13:1472382. doi: 10.3389/fped.2025.1472382. eCollection 2025.
AIM
To evaluate diagnostic combinations of imaging modalities and contrast agents for vesicoureteral reflux (VUR) in children.
METHODS
Studies were retrieved in PubMed, EMBASE, Cochrane Library, Web of science, and China National Knowledge Infrastructure (CNKI) until March 16, 2023. We used bivariate random-effects model and a frequentist model for meta-analysis. Surface under the cumulative ranking curve (SUCRA) was used to rank ceVUS protocols.
RESULTS
19 studies identified 4 diagnostic combinations. Contrast-harmonic ultrasound with SonoVue® (CHSV) had significantly lower sensitivity, specificity, and diagnostic accuracy than VCUG, although its negative predictive value was higher than VCUG. Contrast-harmonic ultrasound with Optison™ (CHOS) was comparable to VCUG across all diagnostic measures. SUCRA analysis favored CHOS, with probabilities of being the best for SEN, SPE, PPV, NPV, DOR, and DA at 50.9%, 16.6%, 42.6%, 57.4%, 36.2%, and 20.4%, respectively.
CONCLUSION
Harmonic VUS with Optison™ may be the optimal protocol for VUR detection in children.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023424510, identifier (CRD42023424510).
目的
评估用于儿童膀胱输尿管反流（VUR）的成像方式和造影剂的诊断组合。
方法
检索截至2023年3月16日的PubMed、EMBASE、Cochrane图书馆、Web of science和中国知网（CNKI）中的研究。我们使用双变量随机效应模型和频率论模型进行荟萃分析。累积排序曲线下面积（SUCRA）用于对造影增强超声（ceVUS）方案进行排序。
结果
19项研究确定了4种诊断组合。使用声诺维®的造影谐波超声（CHSV）的敏感性、特异性和诊断准确性显著低于排尿性膀胱输尿管造影（VCUG），尽管其阴性预测值高于VCUG。使用Optison™的造影谐波超声（CHOS）在所有诊断指标上与VCUG相当。SUCRA分析支持CHOS，其在敏感性、特异性、阳性预测值、阴性预测值、诊断比值比和诊断准确性方面成为最佳方案的概率分别为50.9%、16.6%、42.6%、57.4%、36.2%和20.4%。
结论
使用Optison™的谐波超声造影可能是检测儿童VUR的最佳方案。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023424510，标识符（CRD42023424510）。
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