To investigate whether preoperative localization of sentinel lymph node (SLN) by contrast-enhanced ultrasound (CEUS) can further improve the accuracy of sentinel lymph node biopsy (SLNB). Collect published literatures or conference reports by searching electronic databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) evaluation method is used to evaluate the quality of the screened literatures. The pooled risk ratio of cancer metastasis of SLN identified by CEUS (CE-SLN) compared with SLN not identified by CEUS (nonCE-SLN) is calculated, and the pooled diagnostic accuracy of CE-SLN for pathological status of all SLNs is also evaluated. Through search and screening, a total of 16 studies were included, of which five and seven studies, respectively, entered the meta-analysis of metastatic risk ratio and diagnostic accuracy. The localization rate of preoperative CEUS for sentinel lymph nodes was 70 to 100%. The meta-analysis shows that the risk of metastasis of SLN identified by CEUS is significantly higher than that not identified by CEUS, 26.0% vs 4.6%, and risk ratio (RR) is 6.08 (95% CI 4.17–8.85). In early-stage breast cancer, the pathological status of CE-SLN is a good representative of all SLNs, with a pooled sensitivity of 98% (95% CI 0.94–1.00), pooled specificity of 100% (95% CI 0.99–1.00), diagnostic odds ratio (DOR) of 2153.18 (95% CI 476.53–9729.06), and area under the subject receiver operating characteristic (SROC) curve of 0.9968. In early-stage breast cancer, preoperative localization of SLN by CEUS is expected to further improve the accuracy of sentinel lymph node biopsy (SLNB).

中文翻译：

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CEUS指导的前哨淋巴结活检在早期乳腺癌中的准确性：一项研究综述和荟萃分析。

为了研究术前造影增强超声（CEUS）对前哨淋巴结（SLN）的定位是否可以进一步提高前哨淋巴结活检（SLNB）的准确性。通过搜索电子数据库收集出版的文献或会议报告。诊断准确性研究2的质量评估（QUADAS-2）评估方法用于评估筛选文献的质量。计算通过CEUS（CE-SLN）鉴定出的SLN与未通过CEUS（nonCE-SLN）鉴定出的SLN的合并癌转移风险比，并评估CE-SLN对所有SLN病理状态的合并诊断准确性。通过搜索和筛选，总共包括16项研究，其中分别有5项和7项研究进入了转移风险比和诊断准确性的荟萃分析。术前CEUS对前哨淋巴结的定位率为70％至100％。荟萃分析显示，CEUS鉴定出的SLN转移风险明显高于CEUS未鉴定的，分别为26.0％和4.6％，风险比（RR）为6.08（95％CI 4.17–8.85）。在早期乳腺癌中，CE-SLN的病理状态很好地代表了所有SLN，合并敏感性为98％（95％CI 0.94–1.00），特异性为100％（95％CI 0.99–1.00） ），诊断比值比（DOR）为2153.18（95％CI 476.53–9729.06），受试者接收器工作特性（SROC）曲线下方的面积为0.9968。在早期乳腺癌中，CEUS对SLN进行术前定位有望进一步提高前哨淋巴结活检（SLNB）的准确性。