Abstract：
Real-time thoracic ultrasound-guided pleural biopsy (TUSPB) is an important diagnostic method for pleural diseases. Traditional two-dimensional thoracic ultrasound, as well as newly developed contrast-enhanced ultrasound (CEUS) and ultrasound elastography (UE), are all used as guidance tools for pleural biopsies. Herein, we aimed to determine the diagnostic yield of real-time TUSPB for pleural diseases to better inform the decision-making process.
A literature search of the MEDLINE/PubMed, Embase, and Cochrane Library databases was performed up to June 2023. A binary random-effects model was applied to determine the pooled diagnostic yield.
Fifteen studies comprising 1553 patients with pleural diseases were included and analyzed. The overall diagnostic yield of TUSPB for pleural diseases was 85.58% (95% confidence interval [CI]: 81.57-89.58%). The sensitivity was 77.56% for pleural malignancy and 80.13% for tuberculous pleurisy. The sub-analysis result revealed that CEUS-guided pleural biopsy provided a pooled diagnostic yield of 98.24%, which was higher than that of conventional TUSPB (78.97%; p < 0.01). The overall proportion of adverse events for TUSPB was 6.68% (95% CI: 5.31-8.04%).
Conventional TUSPB has good pooled diagnostic yields and high safety. CEUS and UE are promising guidance tools for pleural biopsy with the potential to increase diagnostic yield.
A literature search of the MEDLINE/PubMed, Embase, and Cochrane Library databases was performed up to June 2023. A binary random-effects model was applied to determine the pooled diagnostic yield.
Fifteen studies comprising 1553 patients with pleural diseases were included and analyzed. The overall diagnostic yield of TUSPB for pleural diseases was 85.58% (95% confidence interval [CI]: 81.57-89.58%). The sensitivity was 77.56% for pleural malignancy and 80.13% for tuberculous pleurisy. The sub-analysis result revealed that CEUS-guided pleural biopsy provided a pooled diagnostic yield of 98.24%, which was higher than that of conventional TUSPB (78.97%; p < 0.01). The overall proportion of adverse events for TUSPB was 6.68% (95% CI: 5.31-8.04%).
Conventional TUSPB has good pooled diagnostic yields and high safety. CEUS and UE are promising guidance tools for pleural biopsy with the potential to increase diagnostic yield.
摘要：
■实时胸部超声引导下的胸膜活检（TUSPB）是胸膜疾病的重要诊断方法。传统的二维胸部超声，以及新开发的超声造影（CEUS）和超声弹性成像（UE），都用作胸膜活检的指导工具。在这里，我们旨在确定实时TUSPB对胸膜疾病的诊断率,以便更好地为决策过程提供信息.
■MEDLINE/PubMed的文献检索,Embase,和Cochrane图书馆数据库进行了到2023年6月。应用二元随机效应模型来确定合并诊断产量。
■15项研究纳入并分析了1553例胸膜疾病患者。TUSPB对胸膜疾病的总诊断率为85.58％（95％置信区间[CI]：81.57-89.58％）。胸膜恶性肿瘤的敏感性为77.56％，结核性胸膜炎的敏感性为80.13％。子分析结果显示，CEUS引导下的胸膜活检提供了98.24％的合并诊断率，高于常规TUSPB(78.97%；p<0.01)。TUSPB不良事件的总比例为6.68%(95%CI:5.31-8.04%)。
■常规TUSPB具有良好的合并诊断产量和高安全性。CEUS和UE是胸膜活检的有希望的指导工具，有可能提高诊断率。
■MEDLINE/PubMed的文献检索,Embase,和Cochrane图书馆数据库进行了到2023年6月。应用二元随机效应模型来确定合并诊断产量。
■15项研究纳入并分析了1553例胸膜疾病患者。TUSPB对胸膜疾病的总诊断率为85.58％（95％置信区间[CI]：81.57-89.58％）。胸膜恶性肿瘤的敏感性为77.56％，结核性胸膜炎的敏感性为80.13％。子分析结果显示，CEUS引导下的胸膜活检提供了98.24％的合并诊断率，高于常规TUSPB(78.97%；p<0.01)。TUSPB不良事件的总比例为6.68%(95%CI:5.31-8.04%)。
■常规TUSPB具有良好的合并诊断产量和高安全性。CEUS和UE是胸膜活检的有希望的指导工具，有可能提高诊断率。
