Diagnostic Value Of Ultrasonic Elastography And Contrast-Enhanced Ultrasound For Thirod Nudles:A Meta-analysis

Objective Ultrasonic Elastography(UE) and Contrast-Enhanced ultrasound (CEUS) have become two important methods in differentiating benign and malignant thyroid nodules (TN),Our objective was to evaluate and compare the diagnostic value of UE and CUES in the diagnosis of a thyroid nodule,Specific-ally,to determine the sensitivity,specificity,accuracy,positive predictive value, negative predictive value and diagnostic odds ratio of the test in differentiating malignant vs benign tumors by meta-analysis.Methods We performed a literature search of PubMed,Cochrane Library, Wan-fang database,CNK,VIP,reviews for English and Chinese studies that looked at UE and CUES in thyroid nodules,in which diagnostic values were present or could be calculated and where UE and CUES results were compared to an acceptable reference standard. Two reviewers independently selected all abstra-cts,and from these,studies to review.Two reviewers also independently checked diagnostic values in the studies or calculated them from data available. A meta-analysis was performed, and pooled diagnostic test values were calculated using a random-effects. Studies were also assessed for quality using the quality assessment for diagnostic accuracy studies tool.Results Five studies were included for review. The quality score of the studies all were high. The pooled estimate sensitivity and specificity of UE were 0.83(95%CI,0.78-0.88) and 0.87(95%CI,0.83-0.91).The pooled estimate sensiti-vity and specificity of CUES were 0.86(95%CI,0.81-0.91) and 0.73(95%CI, 0.68-0.77).The pooled estimate positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio(DOR) of UE were 6.29(95%CI,4.43-8.92),0.18 (95%CI,0.10-0.32),37.07(95%CI,15.62-88.07),The pooled estimate positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of CUES were5.76(95%CI,1.13-29.40),0.19(95%CI,0.13-0.30),29.61(95%CI,9.01-97.34). According to the SROC curve,Q* statistics of UE and CEUS were 0.8590 and 0.8737,and AUC were 0.9248 and 0.9371 respectively.Conclusion Both UE and CUES on differentiation of benign and malignant thyroid nodules are similar, can serve as effective means in differentiating benign and malignant thyroid nodules.