| Background:Over the past two decades,the incidence of Renal cell carcinoma(RCC)has increased globally by about 2% per year,and the incidence of clear cell renal cell carcinoma(ccRCC),the most common subtype of RCC,is also increasing.This tumor is characterized by abundant blood supply,rapid metastasis and high malignancy.Early diagnosis is the key to guide clinical treatment and improve the pr-ognosis of patients.With the gradual maturation of various medical imaging techno l-ogies,imaging examination plays a very important role in the early diagnosis of cc-RCC.contrast-enhanced computed tomography(CECT)and contrast-enhanced ultra-sound(CEUS)are more common clinical imaging examination method.By injecting contrast agent,CECT makes the contrast between lesion and surrounding normal tiss-ue more o bvious,and can show the lesion situation more clearly,which is conducive to the ear ly diagnosis of ccRCC.However,this examination has the disadvantages of radiatio n,hepatorenal toxicity and possible allergy to iodized contrast agent.CEU-S is a microvascular imaging technology,which can acquire the whole enhancement process o f the lesion in real time and dynamically,and clearly reflect the blood perfu-sion situation of the lesion.Its role in the diagnosis of ccRCC is increasingly recogni-zed.Ho wever,there is no meta-analysis comparing the diagnostic ability of CEUS a-nd CEC T for ccRCC.Purpose:To compare the diagnostic value of CEUS and CECT for ccRCC,so as to Purpose:provide reliable and accurate imaging examination means for preoperative diagnosis of ccRCC.Method:"clear cell renal cell carcinoma","contrast enhanced ultrasound","contrastenhanced computed tomography" were selected as search terms in this paper.Literature concerning the diagnosis of ccRCC by CEUS and/or CECT was retrieved from seven databases including Pub Med,Embase and CNKI from January 2002 to January 2023.Literature was selected according to the previously determined inclusion and exclusion criteria.QUADAS-2(quality assessment of diagnostic accuracy studies-2)scale was used to evaluate the quality of the included documents.True positive values,false positive values,true negative values,false negative values and other information in the included literature were extracted for statistical analysis to evaluate the accuracy of the diagnostic method.The I2 value tested the heterogeneity of the included literatures.Subgroup analysis,meta-regression analysis and sensitivity analysis were used to find the source of article heterogeneity.Deek’s funnel plot was used to detect the risk of bias.The clinical application value of the diagnostic method was evaluated by comparing the pretest probability with the posttest probability.Result:A total of 25 literatures were included in this meta-analysis,with a total of 2203 patients and 2248 lesions.The sensitivity and specificity of CEUS and CECT were 0.85(95%CI: 0.80-0.89)/0.87(95%CI: 0.81-0.92),0.85(95%CI: 0.79-0.89)/0.79(95%CI: 0.99-0.89),respectively.0.72-0.85),the combined positive and negative likelihood ratios were 5.50(95%CI: 4.01-7.56)/4.30(95%CI: 3.1-5.9),0.17(95%CI:0.13-0.24)/0.16(95%CI: 0.10-0.24),and the combined odds ratios were 31.47(95%CI: 19.56-50.62)and 26.96(95%CI: 14.48-50.20),respectively.The AUC values of the SROC curves of CEUS and CECT were about 0.92(95%CI: 0.89-0.94)and 0.90(95%CI: 0.87-0.92),respectively.Conclusion:1.The specificity of CEUS in diagnosing ccRCC is higher than that of CECT,and its sensitivity is comparable to that of CECT.Both of them have high accuracy in diagnosing ccRCC.2.Both CEUS and CECT have high clinical application value in the diagnosis of ccRCC. |
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