超声造影诊断附件区肿块的Meta分析
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摘要
目的应用Meta分析的方法评价超声造影(CEUS)诊断附件区肿块的价值。资料与方法系统检索Pub Med、西文生物医学期刊文献数据库(FMJS)、CHKD期刊全文数据库、中国生物医学文献数据库(CBM),收集公开发表的关于CEUS诊断附件区肿块的中英文文献。检索时限自数据库建库至2016年12月31日。对纳入的文献进行异质性检验,并采用诊断精确性研究质量评估(QUADAS-2)量表进行质量评价。应用Stata软件进行统计学分析,得到合并效应量,绘制汇总受试者工作特性曲线(SROC曲线),并计算曲线下面积(AUC),作Deek's漏斗图评估发表偏倚。结果最终共纳入22篇文献,中文文献12篇,英文文献10篇。SROC曲线AUC为0.97。Deek's漏斗图表明本文最终纳入的文献不存在明显发表偏倚(P>0.1)。结论CEUS在诊断附件区肿块中具有较高的诊断效能。
Purpose To assess the value of the diagnosis of adnexal masses with contrast-enhanced ultrasound(CEUS). Materials and Methods Searched Pub Med, FMJS, CHKD, CBM and collected the published Chinese and English articles about the diagnosis of adnexal masses with CEUS. The search deadline was from the establishment of database to December 31, 2016. We tested the heterogeneity of the included articles and evaluated the quality with QUADAS-2. We conducted the statistical analysis with Stata software to obtain the combined effect, drew the summarized receiver operator characteristic(SROC) curve, calculated area under the curve(AUC) and drew Deek's funnel plot evaluate to publication bias. Results A total of 22 articles were included, including 12 Chinese articles and 10 English articles. The AUC of SROC curve was 0.97. Deek's funnel plot showed that the publication bias was not significant(P>0.1) in the included articles. Conclusion CEUS is efficient in the diagnosis of adnexal masses.
Purpose To assess the value of the diagnosis of adnexal masses with contrast-enhanced ultrasound(CEUS). Materials and Methods Searched Pub Med, FMJS, CHKD, CBM and collected the published Chinese and English articles about the diagnosis of adnexal masses with CEUS. The search deadline was from the establishment of database to December 31, 2016. We tested the heterogeneity of the included articles and evaluated the quality with QUADAS-2. We conducted the statistical analysis with Stata software to obtain the combined effect, drew the summarized receiver operator characteristic(SROC) curve, calculated area under the curve(AUC) and drew Deek's funnel plot evaluate to publication bias. Results A total of 22 articles were included, including 12 Chinese articles and 10 English articles. The AUC of SROC curve was 0.97. Deek's funnel plot showed that the publication bias was not significant(P>0.1) in the included articles. Conclusion CEUS is efficient in the diagnosis of adnexal masses.
引文
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[15]郭凤,李际春,刘满梅,等.超声造影在妇科附件区包块诊断中的应用.宁夏医学杂志,2010,32(5):456-458.
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[18]周文格.CDFI与CEUS对卵巢肿瘤的临床对比研究.中国超声医学杂志,2013,29(5):474-476.
[19]张煜,周静,李明星,等.超声造影在卵巢肿瘤定性诊断中的临床价值.临床超声医学杂志,2013,15(6):403-405.
[20]杨帆,杨太珠,罗红,等.超声造影成像在卵巢肿物中的诊断价值.四川大学学报(医学版),2013,44(3):424-428.
[21]胡鸣,洪莉,陈璐,等.超声造影结合参数图像处理在诊断卵巢恶性肿瘤中的应用价值.临床超声医学杂志,2014,16(12):800-802.
[22]Zhang X,Mao Y,Zheng R,et al.The contribution of qualitative CEUS to the determination of malignancy in adnexal masses,indeterminate on conventional US-a multicenter study.PLo S One,2014,9(4):e93843.
[23]牛惠萍,张俊花,薛改琴.超声造影在卵巢肿瘤定性诊断中的应用价值探讨.中国药物与临床,2015,15(3):371-372.
[24]Szymanski M,Socha MW,Kowalkowska ME,et al.Differentiating between benign and malignant adnexal lesions with contrast-enhanced transvaginal ultrasonography.Int J Gynaecol Obstet,2015,131(2):147-151.
[25]李载红,景香香,游佳,等.超声造影在良恶性卵巢肿瘤鉴别诊断中的价值.中国医药导报,2016,13(1):117-120.
[26]郭利清,杨舟.超声造影、CT、MRI在卵巢肿瘤临床应用比较.中国CT和MRI杂志,2016,14(10):92-95.
[27]吴莹,彭鸿灵,赵霞.不同影像学检查诊断卵巢肿瘤:Meta分析.中国医学影像技术,2016,32(8):1244-1249.
[28]张天嵩,钟文昭,李博.实用循证医学方法学.第2版.长沙:中南大学出版社,2014:277-278.
[29]Hu R,Xiang H,Mu Y,et al.Combination of 2-and 3-dimensional contrast-enhanced transvaginal sonography for diagnosis of small adnexal masses.J Ultrasound Med,2014,33(11):1889-1899.
[2]Sha-sha H,Li H,Jie M,et al.DVP parametric imaging for characterizing ovarian masses in contrast-enhanced ultrasound.Eur J Gynaecol Oncol,2015,36(5):574-578.
[3]Whiting PF,Rutjes AW,Westwood ME,et al.QUADAS-2:a revised tool for the quality assessment of diagnostic accuracy studies.Ann Intern Med,2011,155(8):529-536.
[4]Higgins JP,Thompson SG,Deeks JJ,et al.Measuring inconsistency in meta-analyses.BMJ,2003,327(7414):557-560.
[5]Kupesic S,Kurjak A.Contrast-enhanced,three-dimensional power Doppler sonography for differentiation of adnexal masses.Obstet Gynecol,2000,96(3):452-458.
[6]Kurjak A,Kupesic S,Sparac V,et al.Preoperative evaluation of pelvic tumors by Doppler and threedimensional sonography.J Ultrasound Med,2001,20(8):829-840.
[7]Blanco EC,Pastore AR,Fonseca AM,et al.Color doppler sonography with contrast in the differentiation of ovarian tumors.Rev Hosp Clin Fac Med Sao Paulo,2003,58(4):185-192.
[8]Marret H,Sauget S,Giraudeau B,et al.Contrast-enhanced sonography helps in discrimination of benign from malignant adnexal masses.J Ultrasound Med,2004,23(12):1629-1639.
[9]赵胜,陈欣林,陆兆龄,等.超声造影在卵巢病变诊断中的应用.中华医学超声杂志(电子版),2007,4(5):293-295.
[10]周琦,刘百灵,姜珏,等.彩色多普勒超声、超声造影及CA-125对卵巢病变的鉴别诊断价值.南方医科大学学报,2009,29(10):2007-2009.
[11]张金娥,陈文卫,张玉国,等.超声造影增强模式对卵巢肿瘤的诊断价值.中国临床医学影像杂志,2009,20(8):620-622.
[12]Testa AC,Timmerman D,Van Belle V,et al.Intravenous contrast ultrasound examination using contrast-tuned imaging(Cn TI)and the contrast medium Sono Vue for discrimination between benign and malignant adnexal masses with solid components.Ultrasound Obstet Gynecol,2009,34(6):699-710.
[13]Fleischer AC,Lyshchik A,Jones HW,et al.Diagnostic parameters to differentiate benign from malignant ovarian masses with contrast-enhanced transvaginal sonography.J Ultrasound Med,2009,28(10):1273-1280.
[14]王军燕,崔秋丽,汪龙霞,等.超声造影在卵巢良恶性肿块鉴别诊断中的应用.中华医学超声杂志(电子版),2010,7(7):1152-1161.
[15]郭凤,李际春,刘满梅,等.超声造影在妇科附件区包块诊断中的应用.宁夏医学杂志,2010,32(5):456-458.
[16]Veyer L,Marret H,Bleuzen A,et al.Preoperative diagnosis of ovarian tumors using pelvic contrast-enhanced sonography.J Ultrasound Med,2010,29(7):1041-1049.
[17]Huchon C,Metzger U,Bats AS,et al.Value of threedimensional contrast-enhanced power Doppler ultrasound for characterizing adnexal masses.J Obstet Gynaecol Res,2012,38(5):832-840.
[18]周文格.CDFI与CEUS对卵巢肿瘤的临床对比研究.中国超声医学杂志,2013,29(5):474-476.
[19]张煜,周静,李明星,等.超声造影在卵巢肿瘤定性诊断中的临床价值.临床超声医学杂志,2013,15(6):403-405.
[20]杨帆,杨太珠,罗红,等.超声造影成像在卵巢肿物中的诊断价值.四川大学学报(医学版),2013,44(3):424-428.
[21]胡鸣,洪莉,陈璐,等.超声造影结合参数图像处理在诊断卵巢恶性肿瘤中的应用价值.临床超声医学杂志,2014,16(12):800-802.
[22]Zhang X,Mao Y,Zheng R,et al.The contribution of qualitative CEUS to the determination of malignancy in adnexal masses,indeterminate on conventional US-a multicenter study.PLo S One,2014,9(4):e93843.
[23]牛惠萍,张俊花,薛改琴.超声造影在卵巢肿瘤定性诊断中的应用价值探讨.中国药物与临床,2015,15(3):371-372.
[24]Szymanski M,Socha MW,Kowalkowska ME,et al.Differentiating between benign and malignant adnexal lesions with contrast-enhanced transvaginal ultrasonography.Int J Gynaecol Obstet,2015,131(2):147-151.
[25]李载红,景香香,游佳,等.超声造影在良恶性卵巢肿瘤鉴别诊断中的价值.中国医药导报,2016,13(1):117-120.
[26]郭利清,杨舟.超声造影、CT、MRI在卵巢肿瘤临床应用比较.中国CT和MRI杂志,2016,14(10):92-95.
[27]吴莹,彭鸿灵,赵霞.不同影像学检查诊断卵巢肿瘤:Meta分析.中国医学影像技术,2016,32(8):1244-1249.
[28]张天嵩,钟文昭,李博.实用循证医学方法学.第2版.长沙:中南大学出版社,2014:277-278.
[29]Hu R,Xiang H,Mu Y,et al.Combination of 2-and 3-dimensional contrast-enhanced transvaginal sonography for diagnosis of small adnexal masses.J Ultrasound Med,2014,33(11):1889-1899.