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.	农绍军, 温端改, 樊彩斌, 等.≤4 cm肾细胞癌手术方式和预后比较. 中国肿瘤临床, 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.	韩文英. 超声造影与增强CT在肾肿瘤鉴别诊断中的对比研究. 硕士论文, 吉林:吉林大学, 2014.
10.	张建新. 肾癌超声造影和增强CT扫描检查的一致性及特点对比. 中国医药指南, 2013, 11(30):432-432.
11.	王艳, 王辉, 查小霞, 等. 超声造影与增强CT鉴别诊断肾实质性恶性肿瘤的临床价值比较. 现代生物医学进展, 2013, 13(24):4667-4670.
12.	许进, 姚欣. 超声造影与增强CT在鉴别诊断肾实质性肿瘤中的对比研究. 中国医药导报, 2012, 9(33):96-97.
13.	薛继平, 王健, 康春松, 等. 超声造影与增强CT诊断良、恶性肾脏占位性病变的对照研究. 中华医学超声杂志, 2012, 9(12):1079-1082.
14.	袁新春, 王宇, 周爱云, 等. 对比超声造影与CT诊断肾细胞癌. 中国医学影像技术, 2011, 27(12):2502-2505.
15.	李萍, 李凤华, 方华, 等. 超声造影和增强CT在肾实质良恶性病灶诊断中的应用比较. 中国医学影像技术, 2009, 25(5):844-847.
16.	陈松华, 杨斌, 卢光明. 超声造影与增强CT对肾癌的诊断分析. 医学影像学杂志, 2011, 21(9):1382-1384.
17.	沈德娟, 杨斌, 傅宁华. 肾细胞癌的超声造影与增强CT对照研究. 中华超声影像学杂志, 2007, 16(12):1061-1063.
18.	李春香, 姚欣, 李秀英. 超声造影对≤4 cm肾脏良恶性病变的诊断价值. 中国肿瘤临床, 2011, 38(9):520-523.
19.	李维国, 朱轶勇, 阮渊. 超声造影在小肾癌诊断中的价值探讨. 临床泌尿外科杂志, 2009, 24(1):32-43.
20.	刘进, 杨嗣星, 陈文卫. 超声造影在临床诊断小肾癌中的价值. 临床泌尿外科杂志, 2008, 23(7):499-501.
21.	张华, 赵玉珍. 肾细胞癌血管生成的临床进展研究. 中华超声影像学杂志, 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. 农绍军, 温端改, 樊彩斌, 等.≤4 cm肾细胞癌手术方式和预后比较. 中国肿瘤临床, 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. 韩文英. 超声造影与增强CT在肾肿瘤鉴别诊断中的对比研究. 硕士论文, 吉林:吉林大学, 2014.
10. 张建新. 肾癌超声造影和增强CT扫描检查的一致性及特点对比. 中国医药指南, 2013, 11(30):432-432.
11. 王艳, 王辉, 查小霞, 等. 超声造影与增强CT鉴别诊断肾实质性恶性肿瘤的临床价值比较. 现代生物医学进展, 2013, 13(24):4667-4670.
12. 许进, 姚欣. 超声造影与增强CT在鉴别诊断肾实质性肿瘤中的对比研究. 中国医药导报, 2012, 9(33):96-97.
13. 薛继平, 王健, 康春松, 等. 超声造影与增强CT诊断良、恶性肾脏占位性病变的对照研究. 中华医学超声杂志, 2012, 9(12):1079-1082.
14. 袁新春, 王宇, 周爱云, 等. 对比超声造影与CT诊断肾细胞癌. 中国医学影像技术, 2011, 27(12):2502-2505.
15. 李萍, 李凤华, 方华, 等. 超声造影和增强CT在肾实质良恶性病灶诊断中的应用比较. 中国医学影像技术, 2009, 25(5):844-847.
16. 陈松华, 杨斌, 卢光明. 超声造影与增强CT对肾癌的诊断分析. 医学影像学杂志, 2011, 21(9):1382-1384.
17. 沈德娟, 杨斌, 傅宁华. 肾细胞癌的超声造影与增强CT对照研究. 中华超声影像学杂志, 2007, 16(12):1061-1063.
18. 李春香, 姚欣, 李秀英. 超声造影对≤4 cm肾脏良恶性病变的诊断价值. 中国肿瘤临床, 2011, 38(9):520-523.
19. 李维国, 朱轶勇, 阮渊. 超声造影在小肾癌诊断中的价值探讨. 临床泌尿外科杂志, 2009, 24(1):32-43.
20. 刘进, 杨嗣星, 陈文卫. 超声造影在临床诊断小肾癌中的价值. 临床泌尿外科杂志, 2008, 23(7):499-501.
21. 张华, 赵玉珍. 肾细胞癌血管生成的临床进展研究. 中华超声影像学杂志, 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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