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DOI QR Code

Value of Contrast-Enhanced Ultrasonography in the Differential Diagnosis of Enlarged Lymph Nodes: a Meta-Analysis of Diagnostic Accuracy Studies

  • Jin, Ya (Department of Ultrasound in West China Hospital) ;
  • He, Yu-Shuang (Department of Ultrasound in West China Hospital) ;
  • Zhang, Ming-Ming (The Center of Evidence-Based Medicine in West China Hospital, University of Sichuan) ;
  • Parajuly, Shyam Sundar (Department of Ultrasound, Paropakar Maternity and Children Hospital) ;
  • Chen, Shuang (Department of Ultrasound in West China Hospital) ;
  • Zhao, Hai-Na (Department of Ultrasound in West China Hospital) ;
  • Peng, Yu-Lan (Department of Ultrasound in West China Hospital)
  • 발행 : 2015.04.03

초록

Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

키워드

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피인용 문헌

  1. Acoustic Radiation Force Impulse Imaging for the Differentiation of Benign and Malignant Lymph Nodes: A Systematic Review and Meta-Analysis vol.11, pp.11, 2016, https://doi.org/10.1371/journal.pone.0166716
  2. Analysis of Contrast-Enhanced Ultrasound Perfusion Patterns and Time-Intensity Curves for Metastatic Lymph Nodes From Lung Cancer: Preliminary Results pp.02784297, 2018, https://doi.org/10.1002/jum.14345