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갑상선결절에서 추가 횡파 탄성 초음파검사의 진단정확성: 체계적 문헌고찰과 메타분석
박선영 ( Sun-young Park ),송지양 ( Ji Yang Song ),이민진 ( Min Jin Lee ),이경민 ( Kyung Min Lee ),전미혜 ( Mi Hye Jeon ),고려진 ( Ryeo Jin Ko ),김석현 ( Seok-hyun Kim ),강봉주 ( Bong Joo Kang ) 대한갑상선학회 2018 International Journal of Thyroidology Vol.11 No.1
Background and Objectives: The diagnostic performance of shear wave elastography (SWE) combined with ultrasound (US) in the differential diagnosis of thyroid nodules was evaluated. Materials and Methods: 459 articles were collected using KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. The searching words were ‘{(elastography and shear).mp. OR SWE.mp. OR acoustic radiation force impulse.mp. OR ARFI.mp. OR acuson.mp. OR aixplorer.mp.}’. Two authors independently performed article selection and evaluation of the quality of studies with Scottish Intercollegiate Guidelines Network tool. Results: 2582 specimens (thyroid nodules) from 11 studies selected were included in this review. Combined use of US and SWE was reported higher specificity in five literatures, lower specificity in five studies, and no changes in 1 study when compared to US. We performed meta-analysis using data from 10 studies. The pooled sensitivity and specificity of US and SWE group for the differential diagnosis of benign and malignant nodules were 0.91 (I<sup>2</sup>=83.4%), 0.73 (I<sup>2</sup>=95.9%). The pooled sensitivity and specificity of US alone group were 0.88 (I<sup>2</sup>=93.2%), 0.71 (I<sup>2</sup>=92.7%). Conclusion: SWE is not effective in the differential diagnosis of thyroid nodules to minimize unnecessary biopsy of nodules. The included studies showed significant heterogeneity of results.