A Meta-analysis of diagnostic value of conventional ultrasound and new ultrasound techniques for thyroid nodules
HE Xiaona1,2 YIN Lulu1 ZHANG Xiaopeng1 WANG Binru1,2 LIU Haipeng2,3 CHEN Xiao2,3
1.The Second Clinical Medical College of Lanzhou University, Gansu Province, Lanzhou 730030, China;
2.Key Laboratory of Digestive System Tumors of Gansu Province, Gansu Province, Lanzhou 730030, China;
3.Department of General Surgery, Lanzhou University Second Hospital, Gansu Province, Lanzhou 730030, China
Abstract：Objective To evaluate the clinical value of conventional ultrasound, elastography and contrast-enhanced ultrasound in diagnosis of benign and malignant thyroid nodules with Meta analysis. Methods From Janurary 1990 to December 2017, PubMed, Cochrane Library, Embase, CNKI, VIP, CBM and Wanfang data were searched to include literatures, according to the inclusion and exclusion criteria of diagnostic research. QUADAS scale was used to evaluate the quality of the literature included. And Meta-Disc 1.4 software was used to merge sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and draw the summary receiver operating characteristic (SROC curve), and calculate the area under the curve. Results A total of 2174 nodules of 17 literatures studied by 3 diagnostic methods. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the AUC of the conventional ultrasound were 0.59 [95%CI (0.55-0.62)], 0.77 [95%CI (0.74-0.79)], 2.33 [95%CI (1.87-2.89)], 0.53 [95%CI (0.43-0.65)], 4.70 [95%CI (3.18-6.95)], 0.7459, respectively. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the AUC of elastography were 0.84 [95%CI (0.82-0.87)], 0.86 [95%CI (0.84-0.88)], 5.37 [95%CI (0.16-9.12)], 0.20 [95%CI (0.16-0.24)], 30.96 [95%CI (19.87-48.26)], 0.9148, respectively. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the AUC of contrast-enhanced ultrasound were 0.85 [95%CI (0.83-0.88)], 0.87 [95%CI (0.85-0.89)], 6.01 [95%CI (4.30-8.14)], 0.20 [95%CI (0.15-0.26)], 32.82 [95%CI (18.83-57.21)], 0.9070, respectively. Conclusion The accuracy of elastography and contrast-enhanced ultrasonography in distinguishing benign from malignant thyroid nodules is relatively high, while the accuracy of benign and malignant nodules in conventional ultrasound is generally acceptable. However, all three have important implications for the diagnosis of thyroid nodules. Conventional ultrasound remains the most ideal imaging modality for detecting thyroid nodules and describing nodular features. Elastography and contrast-enhanced ultrasonography are valuable in determining the nature of thyroid nodules and can be used as a supplemental diagnostic tool for routine ultrasound.
何晓娜1，2 尹路路1 张小鹏1 王斌儒1，2 刘海鹏2，3 陈晓2,3. 常规超声及超声新技术对甲状腺结节诊断价值的Meta分析[J]. 中国医药导报, 2018, 15(26): 90-95.
HE Xiaona1,2 YIN Lulu1 ZHANG Xiaopeng1 WANG Binru1,2 LIU Haipeng2,3 CHEN Xiao2,3 . A Meta-analysis of diagnostic value of conventional ultrasound and new ultrasound techniques for thyroid nodules . 中国医药导报, 2018, 15(26): 90-95.
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2018, Vol. 15 
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