Ultrasonography, Mammography And Magnetic Resonance Imaging For Diagnosis Of Breast Lesions:A Meta-Analysis

Objective To compare ultrasonography(US), mammography(MAM) and magnetic resonance imaging(MRI) in the diagnosis of breast lesions with Meta analysis.Methods Articles reporting US,MAM and MRI data of patients with known or suspected breast cancers were searched in the PubMed、EMBASE OvidSP、The Cochrane Library、CBM、CNKI、VIP from1995to April2011. Study quality was assessed and data extraction were performed. The software of Meta-disc1.4and Review Manager5.1were used for calculated the sensitivity,specificity, diagnostic odds ratio,summary receiver operating characteristic curves,area under the curve and the heterogenerty. Meta-regression and subgroup analyses were also used.Results Nine articles were included in this Meta-analysis, involving in647benign tumors and723malignant tumors confirmed by pathology. Significant heterogeneity was present besides of the sensitivity of US and MRI in these studies. Meta-regression and subgroup analyses were recognized and controlled in the heterogeneity of Meta-analysis. The age and BI-RADS were selected respectively in the heterogeneity of US and MAM by Meta-regression from many possible factors such as design、country、quanlity、 age and BI-RADS. The affected factors of heterogeneity was not recognized in the MRI.The fixed effect model and random effect model were both correspondingly used. For diagnosis, sensitivities and specificities were respectively US84%[95%CI:(0.81-0.87)].70%[95%CI:(0.66-0.74)],MAM75%[95%CI:(0.72-0.78)].71%[95%CI:(0.67-0.75)],MRI95%[95%CI:(0.93-0.96)].66%[95%CI:(0.62-0.70)]. Area under curve(AUC)of Summary receive operating characteristic(SROC) curve were86.6%,81.6%,95.8%respectively. Besides, the AUC of combined diagnosis using the three methods together was98.6%.Conclusoin Diagnostic value of breast lesions with US,MAM and MRI was high and the combined diagnosis was highest, followed by MRI,US,MAM. Discussing heterogeneity could further improve the level of imaging diagnostic research.