Diagnosis Value Of Contrast-Enhanced Ultrasound And Contrast-Enhanced Computed Tomography For Small Hepatocellular Carcinoma: A Systematic Review

Objective:To assess the accuracy of Contrast-Enhanced ultrasoond and Contrast-Enhanced computed tomgraphy in diagnosing small hepatocellular carcinoma;To evaluate the quality of the current studies involving the value of Contrast-Enhanced Ultrasound and Contrast-Enhanced computed tomgraphy in diagnosing small hepatocellular carcinoma and analyse the sources of bias.Methods:According to Cochrane Collaboration searching strategy for diagnostic tests,We comprehensive collected current studies about Contrast-Enhanced ultrasound and Contrast-Enhanced computed tomgraphy diagnosing hepatocellular carcinomas by electronic retrieval,supplemented by manually retrieval the relevant journals.QUAD AS items were used for quality assessment in our systematic review.Metadisc software was used to analyse sensitvit-y,specificty and draw SROC curves.Results:Totally ten studies were included.The total number of case is 740.Because of many kinds of reference standard, there has a risk of bias. The weighted sensitivity and 95%CI of the enrolled literature about contra st-enhanced ultrasound,Contrast-Enhanced computed tomgraphy,contrast-enha nced ultrasound and Contrast-Enhanced computed tomgraphy in diagnosing small hepatocellular carcinoma were 0.80(0.76-0.84),0.77(0.72-0.82),0.92(0. 87-0.95) respectively,The weighted sensitivity and 95%CI is 0.86 (0.81-0.9 0),0.86(0.81-0.90),0.79(0.70-0.86),respectively.The AUC is 0.9222,0.9209,0.9 199 respectively. it had no statistical significance between the two Q* valu-es of Contrast-enhancedultrasound,Contrast-Enhanced computed tomgr-aphy, contrast-enhanced ultrasound and Contrast-Enhanced computed tomgraphy in diagnosing small hepatocllular carcinoma.Conclusion:In the diagnosis of small hepatocellular,contrast-enhanced ultrasound is an excellent alternative when there are contraindications to Contrast-Enhanced computed tomgraphy (allergy toiodinated contrast media,severe renal failure),because of its safty and well tolerated under a wide range of clinical conditions.