Meta Analysis Of Contrast-enhanced Ultrasonography And Contrast-enhanced CT In Diagnosis Of Renal Cystic Lesions

Objective: Assess the diangostic value of contrast-enhanced ultrasonography and contrast-enhanced CT for benign and malignant renal cystic lesions identification based on Meta analysis.Methods: Develop inclusion criteria and exclusion criteria.Retrieve in databases including PubMed,Cochrane Library,Embase,CNKI and Wanfang Data Service Platform;use both key words and free words in manual retrieval and network retrieval,and search within the literature included in references for the second time.Key words including contrast-enhanced ultrasound,contrast-enhanced computed tomography,renal cystic lesions and so on,are retrieved within Chinese and English literatures,which were dated from the establishment of database to December 2016,about the diagnostic tests of renal cystic lesions with contrast-enhanced ultrasonography and contrast-enhanced CT.According to inclusion criteria and exclusion criteria,2assessors,on their own,screened out literatures that comply with the standards,fetched data and assessed literature quality with Quality Assessment for Diagnostic Accuracy Studies(QUADAS).They also tested the heterogeneity and analyzed the threshold effects of the data contained in literatures with Meta-Disc1.4,calculated the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of renal cystic lesions based on contrast-enhanced ultrasonography and contrast-enhanced CT,respectively,and drew the SROC curves of 2 receivers,and assessed the diagnostic value of contrast-enhanced ultrasonography and contrast-enhanced CT for renal cystic lesions identification in the light of the areas under their SROC curves.Results: Totally 8 diagnostic tests and 364 niduses were involved.The statistical result obtained by Meta analysis is that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio for renal cystic lesions diagnosis with contrast-enhanced ultrasonography are 0.96 [95%CI(0.92,0.98)],0.77 [95%CI(0.70,0.83)],3.69[95%CI(2.87,4.76)],0.07[95%CI(0.04,0.14)] and 54.88[95%CI(25.48,118.24)] respectively,and 0.84[95%CI(0.78,0.89)],0.81 [95%CI(0.75,0.87)],4.12 [95%CI(3.06,5.55)],0.22 [95%CI(0.10,0.45)] and 20.74[95%CI(11.44,35.24)] for the diagnosis with contrast-enhanced CT.The areas under their SROC curves are respectively 0.9173 and 0.8634.Conclusions: Comparing with contrast-enhanced CT,contrast-enhanced ultrasonography has better diagnostic value for renal cystic lesions identification,and is more sensitive to cystic renal cell carcinoma and less liable to the omission of malignant lesions.