Diagnostic Value Of Contrast-enhanced Ultrasound And Enhanced CT In Renal Tumors:A Meta-Analysis

Objective:To systematically and comparatively evaluate the clinical value of contrast-enhanced ultrasound with enhanced CT in the diagnosis of benign and malignant renal tumors.Methods:A systematic search was performed on the databases of China HowNet,Wanfang,PubMed,Embase,and Cochrane Library.The retrieval time was from December 2018 to December 2018,and related literatures on the differential diagnosis of benign and malignant kidney tumors in the same group of contrast-enhanced ultrasound and enhanced CT technology,In strict accordance with the inclusion and exclusion criteria for literature screening,data extraction and methodological quality evaluation.Stata 14.0 software was used to calculate the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio of the two methods for diagnosing malignant renal tumors;draw a summary receiver operating characteristic(SROC)curve and calculate the area under the curve And explore the extent and potential sources of heterogeneity.Results:A total of 10 controlled studies were included,with a total of 1,290 lesions.The combined sensitivity and specificity of contrast-enhanced ultrasound and enhanced CT to detect renal tumors were 0.95 [95% confidence interval(CI): 0.93 to 0.96] and 0.90(95% CI: 0.85 to 0.93),0.75(95% CI: 0.66 to 0.83)and 0.72(95% CI: 0.63 to 0.80).The diagnostic odds ratios were 59(95% CI: 35 to 100)and 27(95 % CI: 19 to 40),and the areas under the SROC curve are 0.95(95% CI: 0.93 to 0.97)and 0.89(95% CI: 0.86 to 0.91),respectively.The contrast,sensitivity,specificity,and diagnostic odds ratio of contrast-enhanced ultrasound and enhanced CT for renal tumors?4 cm are 0.95(95% CI: 0.92 to 0.97)and 0.87(95% CI: 0.82 to 0.92),0.76(95% CI :0.65 to 0.86)and 0.75(95% CI: 0.65 to 0.86),63(95% CI: 34 to 116),and 21(95% CI: 10 to 46).The areas under the SROC curve were 0.95(95% CI: 0.93 to 0.97)and 0.90(95%CI: 0.87 to 0.92).Conclusion:Contrast-enhanced ultrasound has the same high sensitivityand moderate specificity as enhanced CT and enhanced CT in the diagnosis of renal tumors.Contrast-enhanced ultrasound is more sensitive than enhanced CT in the diagnosis of renal tumors with a diameter of less than 4 cm.