Kinkel K, Kaji Y, Yu K K, Segal M R, Lu Y, Powell C B, Hricak H
Department of Radiology, University of California-San Francisco 94143-0628, USA.
Radiology. 1999 Sep;212(3):711-8. doi: 10.1148/radiology.212.3.r99au29711.
To apply a meta-analysis to compare the utility of computed tomography (CT), ultrasonography (US), and magnetic resonance (MR) imaging in staging endometrial cancer.
Data were obtained from a MEDLINE literature search and from manual reviews of article bibliographies. Articles were selected that included results in patients with proved endometrial cancer and imaging-histopathologic correlation and that presented data that allowed calculation of contingency tables. Data for the imaging evaluation of myometrial and cervical invasion were abstracted independently by two authors. Data on year of publication, International Federation of Gynecology and Obstetrics (FIGO) stage distribution, and methodologic quality were also collected. A subgroup analysis was performed to compare contrast medium-enhanced MR imaging with nonenhanced MR imaging, US, and CT.
Six studies met the inclusion criteria for CT; 16, for US; and 25, for MR imaging. Summary receiver operating characteristic analysis showed no significant differences in the overall performance of CT, US, and MR imaging. In the assessment of myometrial invasion, however, contrast-enhanced MR imaging performed significantly better than did nonenhanced MR imaging or US (P < .002) and demonstrated a trend toward better results, as compared with CT. The lack of data on the assessment of cervical invasion at CT or US prevented meta-analytic comparison with data obtained at MR imaging. Results were not influenced by year of publication, FIGO stage distribution, or methodologic quality.
Although US, CT, or MR imaging can be used in the pretreatment evaluation of endometrial cancer, contrast-enhanced MR imaging offers "one-stop" examination with the highest efficacy.
应用荟萃分析比较计算机断层扫描（CT）、超声检查（US）和磁共振成像（MR）在子宫内膜癌分期中的应用价值。
通过检索MEDLINE文献及人工查阅文章参考文献获取数据。入选的文章需包含经证实的子宫内膜癌患者的研究结果以及影像学与组织病理学的相关性，且提供的数据应能计算列联表。两名作者独立提取关于子宫肌层和宫颈侵犯的影像学评估数据。还收集了发表年份、国际妇产科联盟（FIGO）分期分布及方法学质量的数据。进行亚组分析以比较对比剂增强磁共振成像与非增强磁共振成像、超声检查及CT。
六项研究符合CT的纳入标准；16项符合超声检查的纳入标准；25项符合磁共振成像的纳入标准。汇总的受试者工作特征分析显示，CT、超声检查和磁共振成像的总体性能无显著差异。然而，在评估子宫肌层侵犯方面，对比剂增强磁共振成像的表现明显优于非增强磁共振成像或超声检查（P <.002），与CT相比也显示出更好结果的趋势。CT或超声检查在评估宫颈侵犯方面缺乏数据，无法与磁共振成像获得的数据进行荟萃分析比较。结果不受发表年份、FIGO分期分布或方法学质量的影响。
虽然超声检查、CT或磁共振成像均可用于子宫内膜癌的治疗前评估，但对比剂增强磁共振成像能提供最高效的“一站式”检查。
