Diagnostic Value of Contrast-enhanced Ultrasound and Contrast-enhanced CT for Renal Solid Space-occupying Lesions: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENBang-tao ^1,2 , CHIJun-jie ³ , HOUShi-jie ⁴ , ZHANGYun ² , SONGShao-juan ² , LIUMing-she ² ,  ZHAOZhong-fu ²

1. Department of Infectious Disease, the First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China;
2. Department of Infectious Disease, Heping Hospital of Changzhi Medical College, Changzhi 046000, China;
3. Department of Urinary Surgery, the First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China;
4. Department of Nephrology, Heping Hospital of Changzhi Medical College, Changzhi 046000, China;

Corresponding?author：

ZHAOZhong-fu, Email: zhaozf_1226@163.com

Keywords：

Renal; Renal solid space-occupying; Contrast-enhanced ultrasound; Contrast-enhanced CT; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20150174

Video：

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Objective To systematically review the differential diagnostic value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced CT (CECT) for renal solid space-occupying lesions. Methods Databases including EMbase, PubMed, The Cochrane Library (Issue 11, 2014), CNKI, CBM, VIP and WanFang Data were searched for diagnostic tests about CEUS and CECT for renal solid space-occupying lesions from inception to September, 2014. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. Results A total of 13 studies involving 754 specimens were included. The results of meta-analysis showed that:the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (combined effect and its 95%CI) in the CEUS group were 0.96 (95%CI 0.94 to 0.97), 0.77 (95%CI 0.70 to 0.83), 3.82 (95%CI 2.93 to 4.97), 0.06 (95%CI 0.04 to 0.10), 64.33 (95%CI 36.79 to 112.51), and in the CECT group were 0.84 (95%CI 0.81 to 0.87), 0.73 (95%CI 0.65 to 0.79), 2.81 (95%CI 2.22 to 3.56), 0.23 (95%CI 0.16 to 0.34), 13.85 (95%CI 6.79 to 28.26). There were significant differences between the CEUS group (0.960 8, 95%CI 0.927 3 to 0.994 3) and the CECT group (0.866 8, 95%CI 0.788 8 to 0.944 8) in the area under the summary receiver operating characteristic (SROC) curve (P<0.05). The similar results were observed in cases with small renal tumors≤4 cm (AUC:0.973 7 vs. 0.861 3, P<0.05). Conclusion CEUS has higher differential diagnostic value than CECT for renal solid space-occupying lesions.

Citation： CHENBang-tao, CHIJun-jie, HOUShi-jie, ZHANGYun, SONGShao-juan, LIUMing-she, ZHAOZhong-fu. Diagnostic Value of Contrast-enhanced Ultrasound and Contrast-enhanced CT for Renal Solid Space-occupying Lesions: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1042-1048. doi: 10.7507/1672-2531.20150174 Copy

1.	Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin, 2013, 63(1):11-30.
2.	Thorelius L. Contrast-enhanced Ultrasound:Beyond the Liver. Eur Radiol, 2003, 13(Suppl 3):N91-108.
3.	Tranquart F, Correas JM, Martegani A, et al. Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol, 2004, 85(1):31-36.
4.	Park BK, Kim SH, Choi HJ. Characterization of Renal Cell Carcinoma Using Agent Detection Imaging:Comparison With Grayscale US. Korean J Radiol, 2005, 6(3):173-178.
5.	Tamai H, Takiguchi Y, Masashi O, et al. Contrast-Enhanced Ultrasonography in the Diagnosis of Solid Renal Tumors. J Ultrasound Med, 2005, 24(12):1635-1640.
6.	農紹軍, 溫端改, 樊彩斌, 等.≤4 cm腎細胞癌手術方式和預后比較. 中國腫瘤臨床, 2007, 34(22):1291-1293.
7.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3(1):25-38.
8.	Zamora J, Abraira V, Muriel A, et al. Meta-Disc:a software for meta-analysis of test accuracy data. BMC Med Res Methodol, 2006, 6(1):31.
9.	韓文英. 超聲造影與增強CT在腎腫瘤鑒別診斷中的對比研究. 碩士論文, 吉林:吉林大學, 2014.
10.	張建新. 腎癌超聲造影和增強CT掃描檢查的一致性及特點對比. 中國醫藥指南, 2013, 11(30):432-432.
11.	王艷, 王輝, 查小霞, 等. 超聲造影與增強CT鑒別診斷腎實質性惡性腫瘤的臨床價值比較. 現代生物醫學進展, 2013, 13(24):4667-4670.
12.	許進, 姚欣. 超聲造影與增強CT在鑒別診斷腎實質性腫瘤中的對比研究. 中國醫藥導報, 2012, 9(33):96-97.
13.	薛繼平, 王健, 康春松, 等. 超聲造影與增強CT診斷良、惡性腎臟占位性病變的對照研究. 中華醫學超聲雜志, 2012, 9(12):1079-1082.
14.	袁新春, 王宇, 周愛云, 等. 對比超聲造影與CT診斷腎細胞癌. 中國醫學影像技術, 2011, 27(12):2502-2505.
15.	李萍, 李鳳華, 方華, 等. 超聲造影和增強CT在腎實質良惡性病灶診斷中的應用比較. 中國醫學影像技術, 2009, 25(5):844-847.
16.	陳松華, 楊斌, 盧光明. 超聲造影與增強CT對腎癌的診斷分析. 醫學影像學雜志, 2011, 21(9):1382-1384.
17.	沈德娟, 楊斌, 傅寧華. 腎細胞癌的超聲造影與增強CT對照研究. 中華超聲影像學雜志, 2007, 16(12):1061-1063.
18.	李春香, 姚欣, 李秀英. 超聲造影對≤4 cm腎臟良惡性病變的診斷價值. 中國腫瘤臨床, 2011, 38(9):520-523.
19.	李維國, 朱軼勇, 阮淵. 超聲造影在小腎癌診斷中的價值探討. 臨床泌尿外科雜志, 2009, 24(1):32-43.
20.	劉進, 楊嗣星, 陳文衛. 超聲造影在臨床診斷小腎癌中的價值. 臨床泌尿外科雜志, 2008, 23(7):499-501.
21.	張華, 趙玉珍. 腎細胞癌血管生成的臨床進展研究. 中華超聲影像學雜志, 2003, 12(3):172-173.
22.	Albrecht T, Hoffmann, Schmitz, et al. Phase-inversion Sonography during the Liver-specific Late Phase of Contrast Enhancement:Improved Detection of Liver Metastases. AJR Am J Roentgenol, 2001, 176(5):1191-1198.
23.	Robbin ML, Lockhart ME, Barr RG. Renal imaging with ultrasound contrast:current status. Radio Clin North Am, 2003, 41(5):963-978.
24.	Goldberg BB, Liu JB, Burns PN, et al. Galactosebased intravenous sonographic contrast agent:experimental studies. J Ultrasound Med, 1993, 12(8):463-470.
25.	Jiang X, Dai Q, Liu J, et al. Feasibility study of an ultrasound contrast agent (levovist) in color doppler imaging of liver neoplasms. Chin Med Sci, 1999, 4(3):167-169.
26.	Rizzatto G, Martegani A, Chersevani R, et al. Importance of staging of breast cancer and role of contrast ultrasound. Eur Radiol, 2001, 11(S3):E47-E52.
27.	Lencioni R, Cioni D, Bartolozzi C. Tissue Harmonic and Contrast-specific Imaging:Back to Gray Scale in Ultrasound. Eur Radiol, 2002, 12(1):151-165.

1. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin, 2013, 63(1):11-30.
2. Thorelius L. Contrast-enhanced Ultrasound:Beyond the Liver. Eur Radiol, 2003, 13(Suppl 3):N91-108.
3. Tranquart F, Correas JM, Martegani A, et al. Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol, 2004, 85(1):31-36.
4. Park BK, Kim SH, Choi HJ. Characterization of Renal Cell Carcinoma Using Agent Detection Imaging:Comparison With Grayscale US. Korean J Radiol, 2005, 6(3):173-178.
5. Tamai H, Takiguchi Y, Masashi O, et al. Contrast-Enhanced Ultrasonography in the Diagnosis of Solid Renal Tumors. J Ultrasound Med, 2005, 24(12):1635-1640.
6. 農紹軍, 溫端改, 樊彩斌, 等.≤4 cm腎細胞癌手術方式和預后比較. 中國腫瘤臨床, 2007, 34(22):1291-1293.
7. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3(1):25-38.
8. Zamora J, Abraira V, Muriel A, et al. Meta-Disc:a software for meta-analysis of test accuracy data. BMC Med Res Methodol, 2006, 6(1):31.
9. 韓文英. 超聲造影與增強CT在腎腫瘤鑒別診斷中的對比研究. 碩士論文, 吉林:吉林大學, 2014.
10. 張建新. 腎癌超聲造影和增強CT掃描檢查的一致性及特點對比. 中國醫藥指南, 2013, 11(30):432-432.
11. 王艷, 王輝, 查小霞, 等. 超聲造影與增強CT鑒別診斷腎實質性惡性腫瘤的臨床價值比較. 現代生物醫學進展, 2013, 13(24):4667-4670.
12. 許進, 姚欣. 超聲造影與增強CT在鑒別診斷腎實質性腫瘤中的對比研究. 中國醫藥導報, 2012, 9(33):96-97.
13. 薛繼平, 王健, 康春松, 等. 超聲造影與增強CT診斷良、惡性腎臟占位性病變的對照研究. 中華醫學超聲雜志, 2012, 9(12):1079-1082.
14. 袁新春, 王宇, 周愛云, 等. 對比超聲造影與CT診斷腎細胞癌. 中國醫學影像技術, 2011, 27(12):2502-2505.
15. 李萍, 李鳳華, 方華, 等. 超聲造影和增強CT在腎實質良惡性病灶診斷中的應用比較. 中國醫學影像技術, 2009, 25(5):844-847.
16. 陳松華, 楊斌, 盧光明. 超聲造影與增強CT對腎癌的診斷分析. 醫學影像學雜志, 2011, 21(9):1382-1384.
17. 沈德娟, 楊斌, 傅寧華. 腎細胞癌的超聲造影與增強CT對照研究. 中華超聲影像學雜志, 2007, 16(12):1061-1063.
18. 李春香, 姚欣, 李秀英. 超聲造影對≤4 cm腎臟良惡性病變的診斷價值. 中國腫瘤臨床, 2011, 38(9):520-523.
19. 李維國, 朱軼勇, 阮淵. 超聲造影在小腎癌診斷中的價值探討. 臨床泌尿外科雜志, 2009, 24(1):32-43.
20. 劉進, 楊嗣星, 陳文衛. 超聲造影在臨床診斷小腎癌中的價值. 臨床泌尿外科雜志, 2008, 23(7):499-501.
21. 張華, 趙玉珍. 腎細胞癌血管生成的臨床進展研究. 中華超聲影像學雜志, 2003, 12(3):172-173.
22. Albrecht T, Hoffmann, Schmitz, et al. Phase-inversion Sonography during the Liver-specific Late Phase of Contrast Enhancement:Improved Detection of Liver Metastases. AJR Am J Roentgenol, 2001, 176(5):1191-1198.
23. Robbin ML, Lockhart ME, Barr RG. Renal imaging with ultrasound contrast:current status. Radio Clin North Am, 2003, 41(5):963-978.
24. Goldberg BB, Liu JB, Burns PN, et al. Galactosebased intravenous sonographic contrast agent:experimental studies. J Ultrasound Med, 1993, 12(8):463-470.
25. Jiang X, Dai Q, Liu J, et al. Feasibility study of an ultrasound contrast agent (levovist) in color doppler imaging of liver neoplasms. Chin Med Sci, 1999, 4(3):167-169.
26. Rizzatto G, Martegani A, Chersevani R, et al. Importance of staging of breast cancer and role of contrast ultrasound. Eur Radiol, 2001, 11(S3):E47-E52.
27. Lencioni R, Cioni D, Bartolozzi C. Tissue Harmonic and Contrast-specific Imaging:Back to Gray Scale in Ultrasound. Eur Radiol, 2002, 12(1):151-165.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Contrast-enhanced Ultrasound and Contrast-enhanced CT for Renal Solid Space-occupying Lesions: A Meta-analysis

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