经阴道超声诊断子宫腺肌病的诊断准确性：系统评价与荟萃分析
Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis.
作者信息
Meredith Susanna M, Sanchez-Ramos Luis, Kaunitz Andrew M
机构信息
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL, USA.
出版信息
Am J Obstet Gynecol. 2009 Jul;201(1):107.e1-6. doi: 10.1016/j.ajog.2009.03.021. Epub 2009 Apr 26.
OBJECTIVE
The purpose of this study was to critically appraise the diagnostic accuracy of transvaginal sonography for diagnosing adenomyosis.
STUDY DESIGN
Computerized databases were used to identify relevant reports published between 1966 and 2007 reporting data on the accuracy of transvaginal sonography for diagnosing adenomyosis in women having hysterectomy. The presence or absence of adenomyosis was confirmed by histopathologic analysis of hysterectomy specimens. The total analysis included 14 trials with 1895 aggregate participants. Two authors independently assessed methodological quality and constructed tables for the assessment of diagnostic measures.
RESULTS
Transvaginal ultrasound predicted adenomyosis with a likelihood ratio of 4.67 (95% confidence interval [CI], 3.13-6.17). The overall prevalence of adenomyosis was 27.9% (95% CI, 25.5-30.3). The probability of adenomyosis with an abnormal transvaginal ultrasound was 66.2% (95% CI, 61.6- 70.6). The probability of adenomyosis with a normal transvaginal ultrasound was 9.1% (95% CI, 7.3-11.1).
CONCLUSION
Transvaginal sonography appears to be an accurate diagnostic test for adenomyosis.
目的
本研究旨在严格评估经阴道超声诊断子宫腺肌病的诊断准确性。
研究设计
利用计算机数据库识别1966年至2007年间发表的相关报告，这些报告报道了经阴道超声对行子宫切除术女性诊断子宫腺肌病准确性的数据。通过子宫切除标本的组织病理学分析确认子宫腺肌病的存在与否。总共分析了14项试验，共有1895名参与者。两位作者独立评估方法学质量并构建用于评估诊断措施的表格。
结果
经阴道超声预测子宫腺肌病的似然比为4.67（95%置信区间[CI]，3.13 - 6.17）。子宫腺肌病的总体患病率为27.9%（95%CI，25.5 - 30.3）。经阴道超声异常时子宫腺肌病的概率为66.2%（95%CI，61.6 - 70.6）。经阴道超声正常时子宫腺肌病的概率为9.1%（95%CI，7.3 - 11.1）。
结论
经阴道超声似乎是诊断子宫腺肌病的一种准确诊断方法。
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