Accuracy of contrast-enhanced ultrasound in the identification of thyroid nodules: a meta-analysis

This meta-analysis aimed to identify the accuracy of contrast-enhanced ultrasonography (CEUS) on the diagnosis of thyroid nodules. PubMed, Chinese Biomedical Medical databases (CNKI), Wan Fang (Chinese), and EBSCO database were searched from inception through April 15, 2015 without language and geographic restrictions. MetaDisc version 1.4 software was applied for this meta-analysis. We calculated the summary statistics for sensitivity (Sen), specificity (Spe), positive and negative likelihood ratio (LR+/LR-), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve. Twenty-five eligible studies were included in this meta-analysis. A total of 424 in 1154 nodules is malignant thyroid tumors. After all thyroid lesions were histologically confirmed by CEUS, the pooled Sen was 0.88 (95% confidence interval [CI] 0.85-0.91); the pooled Spe was 0.90 (95% CI 0.88-0.92). The pooled positive LR+ was 8.69(95% CI 5.78-13.09); the pooled negative LR- was 0.15 (95% CI 0.12-0.19). The pooled DOR of CEUS in the diagnosis of thyroid nodules was 63.18 (95% CI 37.82-105.53). The area under the SROC curve was 0.946 (standard error [SE] = 0.010). Our meta-analysis indicates that CEUS may have high accuracy in diagnosis the difference between benign and malignant thyroid nodules. US is a traditional tool in the diagnosis thyroid nodules. However, with the development of science and technology, the emerging of CEUS significantly improve accuracy in the diagnosis thyroid nodules.