超声超微血管成像及弹性成像在乳腺肿块诊断效能的Meta分析

超声超微血管成像及弹性成像在乳腺肿块诊断效能的Meta分析摘要目的：使用meta分析研究超微血管成像及弹性成像技术对乳腺肿块良恶性的诊断效能。方法：在万方、维普、中国知网等数据库中以“超声超微血管成像”、“弹性成像”、“乳腺肿块”“superb microvascular imaging'”、“elastography”、“breast cancer'”等为检索关键词进行文献检索，使用RevMan5.4评估纳入文献的质量，statal7.0对提取的数据进行统计分析，计算SMI、UE以及SM和UE联合使用的合并灵敏度、特异度及诊断比值比等指标，绘制合并受试者工作特征曲线(Summary Receiver Operating CharacteristicCurve,SROC并计算曲线下面积(Area Under the Curve,AUC),采用P检验分析各研究之间的异质性，进行Meta回归分析探索异质性来源，绘制Deeks漏斗图评估发表偏倚。结果：本次研究一共纳入5篇文献，共912名患者，978个乳腺结节。各研究间存在异质性，纳入病人的结节类型、诊断标准不同与是否和常规超声结合使用是异质性的来源。SMI和UE的合并敏感性分别为0.90(95%CI:0.86-0.94)和0.89(95%CI:0.82-0.94),合并特异度分别为0.75(95%CI:0.59-0.86)和0.81(95%CI:0.73-0.87),SR0C曲线下面积分别为0.92(95%CI:0.89-0.94)和0.93(95%CI:0.90-0.95);SM1和UE联合使用的合并敏感性为0.95(95%CI:0.91-0.98),合并特异度为0.92(95%CI:0.85-0.96),SR0C曲线下面积为0.98(95%CI:0.96-0.99)。结论：超微血管成像及弹性成像技术对鉴别乳腺肿块恶性病变均有较高的诊断价值，当两者联合使用时，诊断效能显著提高。关键词：超声超微血管成像：超声弹性成像：乳腺肿块：meta分析AbstractObjective:To study the diagnostic efficacy of super microvascular imaging andelastography techniques for benign and malignant breast masses using meta-analysis.Method:Literature search was conducted on databases such as Wanfang,VIP,and CNKIusing keywords such as "superb microvascular imaging ""elastography","breast mass","breast cancer",etc.RevMan5.4 was used to evaluate the quality of the included literature.Stata 17.0 was used to statistically analyze the extracted data,and the combined sensitivity,specificity and diagnostic odds of SMI,UE,and the combination of SMI and UE werecalculated,draw a summary receiver operating characteristic curve (SROC)and calculate thearea under the curve (AUC).Use I2 test to analyze heterogeneity between studies,conductmeta-regression analysis to explore the source of heterogeneity,and draw a Deeks funnel toevaluate publication bias.Result:A total of 5 articles were included in this study,with a total of 912 patients and978 breast nodules.There is heterogeneity among them and sources of heterogeneity lie in thedifferent types of nodules,diagnostic criteria,and whether to use them in combination withconventional ultrasound in patients.The sensitivity of SMI was 0.90 (95%CI:0.86-0.94),thespecificity was0.75(95%C0.59-0.86),AUC was0.92(95%C:0.89-0.94):UE was0.89(95%C:0.82-0.94),0.81(95%CI:0.73-0.87),0.93(95%CI:0.90-0.95);The combinationof SMI and UE was0.95(95%CI:0.91-0.98),0.92(95%C:0.85-0.96),0.98(95%CI:0.96-0.99).Conclusion:Both super microvascular imaging and elastography techniques have highdiagnostic value in distinguishing malignant breast masses.When combined,the diagnosticefficiency is significantly improved.Key words:Superb microvascular imaging;Ultrasound elastography;Breastmass;Meta analysis目录☑引言】资料与方法….31.1文献检索.31.2纳入和排除标准31.2.1纳入标准..31.2.2排除标准…31.3文献质量评价….31.4统计学处理.32结果42.1文献检索基本情况42.2纳入文献基本信息.42.3文献质量评价.52.4发表偏倚….62.5异质性检验.62.6诊断效能分析…82.7Meta回归分析..102.7.1SMI....102.7.2UE.113讨论12结论….13参考文献.14致谢….17◇