title: Diagnostic Accuracy of Hepatic Vein Arrival Time Performed with Contrast-Enhanced Ultrasonography for Cirrhosis: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  We identified reports in the literature regarding the diagnostic accuracy of hepatic vein arrival time (HVAT) measured by contrast-enhanced ultrasonography (CEUS) to assess hepatic fibrosis in cirrhosis.
  
  
  METHODS
  The Ovid MEDLINE, Embase, and Cochrane databases were searched for all studies published up to 23 July 2015 that evaluated liver status using CEUS and liver biopsy (LB). The QUADAS-II (quality assessment of diagnostic accuracy studies-II) was applied to assess the internal validity of the diagnostic studies. Selected studies were subjected to a meta-analysis with MetaDisc 1.4 and RevMan 5.3.
  
  
  RESULTS
  A total of 12 studies including 844 patients with chronic liver disease met our inclusion criteria. The overall summary sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the HVAT measured by CEUS for the detection of cirrhosis compared to LB were 0.83 (95% confidence interval [CI], 0.77 to 0.89), 0.75 (95% CI, 0.69 to 0.79), 3.45 (95% CI, 1.60 to 7.43), and 0.28 (95% CI, 0.10 to 0.74), respectively. The summary diagnostic odds ratio (random effects model) was 15.23 (95% CI, 3.07 to 75.47), the summary receiver operator characteristics area under the curve was 0.74 (standard error [SE]=0.14), and the index Q was 0.69 (SE=0.11).
  
  
  CONCLUSIONS
  Based on a systematic review, the measurement of HVAT by CEUS exhibited an increased accuracy and correlation for the detection of cirrhosis.
authors.affiliation: Department of Nursing, Keimyung University College of Nursing, Daegu, Korea.
authors.forename: Gaeun
authors.initials: G
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kwang Yong
authors.initials: KY
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
mesh_terms: D001706:Biopsy; D003287:Contrast Media; D004268:DNA-Binding Proteins; D029721:Drosophila Proteins; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D016013:Likelihood Functions; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014157:Transcription Factors; D014463:Ultrasonography; D018608:Ultrasonography, Doppler
chemical_list: D003287:Contrast Media; D004268:DNA-Binding Proteins; D029721:Drosophila Proteins; D014157:Transcription Factors; C066735:odd protein, Drosophila
keywords: Contrast-enhanced ultrasonography; Hepatic fibrosis; Meta-analysis; Systematic review