Diagnostic Value Of Contrast-enhanced Ultrasound And Contrast-enhanced CT In Solid Renal Cell Carcinoma

Objective To assess the diangostic value of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT)in solid renal cell carcinoma by Meta analysis.Methods Relevant literatures were searched in PubMed,The Cochrane Library,EMBASE,CNKI,CBM,VIP and WanFang Data.In addition,Google Scholar was used to supplementary retrieval.The retrieval time was until April 2019.QUADAS tool was used to evaluate the quality of the included studies.The data included in the literatures were extracted to calculate the pooled sensitivity?specificity?positive likelihood ratio?negative likelihood ratio?odds ratio.The areas under the summary receiver operating characteristic curves(SROC-AUC)for CEUS and CECT were calculated,respectively.Results A total of 3312 articles were retrieved.According to the inclusion and exclusion criteria,twenty-two studies with 1996 lesions were included.Twenty-one studies were included on CEUS.The pooled sensitivity?specificity?likelihood ratio?negative likelihood ratio?diagnostic odds ratio and 95%Cl for CEUS were 0.93(0.92-0.94),0.80(0.77-0.83),3.77(2.70-5.28),0.11(0.07-0.16),43.31(23.42-80.09),respectively SROC-AUC for CEUS was 0.93(SE=0.0223).Seven studies were included on CECT.The pooled sensitivity?specificity?positive likelihood ratio?negative likelihood ratio?diagnostic odds ratio and 95%CI for CECT were 0.89(0.86-0.92),0.67(0.58-0.76),2.45(1.86-3.25),0.17(0.11-0.25),16.58(9.07-30.32),respectively.SROC-AUC for CECT was 0.87(SE=0.0195).Z test was used to compare the SROC-AUCs.Z(CEUS vs CECT)=2.02 and P<0.05,which indicated that the diagnostic accuracy of CECT was higher than that of CECT.Subgroup analysis indicated that the human species may influence the diagnostic efficacy of CEUS.Conclusion Contrast-enhanced ultrasound had excellent diagnostic accuracy for solid renal cell carcinoma,and contrast-enhanced CT had good diagnostic accuracy for solid renal cell carcinoma.The sensitivity?specificity and diagnostic accuracy of contrast-enhanced ultrasound were higher than those of contrast-enhanced CT in the diagnosis of solid renal cell carcinoma.