Wang Bo, Zhang Yong, Chen Shuangshuang, Xiang Xiaowei, Wen Juan, Yi Mei, He Baiyun, Hu Bing
Department of Ultrasonic Imaging, Affiliated Renhe Hospital of China Three Gorges University, Yichang.
Department of Nephrology, The First Affiliated Hospital of Yangtze University, Jingzhou.
Medicine (Baltimore). 2019 Jul;98(29):e16449. doi: 10.1097/MD.0000000000016449.
The aim of the study was to evaluate the diagnostic accuracy of cervical elastography in predicting preterm delivery (PTD).
We searched the PubMed, EMBASE, and Cochrane databases to identify relevant studies that applied ultrasound (US) elastography to assess cervical stiffness and predict PTD. All the studies were published before December 11, 2018, and only studies published in English were collected. The cervical length (CL) was considered a comparator, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was applied to assess the quality of the included studies. Summary receiver operating characteristic (SROC) modeling was performed to evaluate the diagnostic performance of cervical elastography in predicting PTD. Subgroup analyses were also performed.
Seven studies, including 1488 pregnant women, were included in this meta-analysis. Cervical elastography showed a summary sensitivity of 0.84 [95% confidence interval (CI): 0.68, 0.93], a specificity of 0.82 (95% CI: 0.63, 0.93), a diagnostic odds ratio of 25 (95% CI: 7, 93), and an area under the curve (AUC) of SROC of 0.90 (95% CI: 0.87-0.93). CL measurement showed that the AUC of SROC was 0.60 (95% CI: 0.56-0.64). The results of subgroup analysis showed that the summary sensitivity and specificity were different in the QUADAS-2 score subgroups.
Cervical elastography is a promising and reliable method to predict PTD. Cervical elastography showed better diagnostic performance to predict PTD than CL measurement.
本研究旨在评估宫颈弹性成像在预测早产（PTD）方面的诊断准确性。
我们检索了PubMed、EMBASE和Cochrane数据库，以确定应用超声（US）弹性成像评估宫颈硬度并预测PTD的相关研究。所有研究均在2018年12月11日前发表，仅收集英文发表的研究。将宫颈长度（CL）作为对照，并应用诊断准确性研究质量评估-2（QUADAS-2）工具评估纳入研究的质量。进行汇总受试者工作特征（SROC）建模以评估宫颈弹性成像在预测PTD方面的诊断性能。还进行了亚组分析。
本荟萃分析纳入了7项研究，共1488名孕妇。宫颈弹性成像的汇总敏感性为0.84[95%置信区间（CI）：0.68，0.93]，特异性为0.82（95%CI：0.63，0.93），诊断比值比为25（95%CI：7，93），SROC曲线下面积（AUC）为0.90（95%CI：0.87 - 0.93）。CL测量显示SROC的AUC为0.60（95%CI：0.56 - 0.64）。亚组分析结果显示，QUADAS-2评分亚组中的汇总敏感性和特异性有所不同。
宫颈弹性成像是一种有前景且可靠的预测PTD的方法。宫颈弹性成像在预测PTD方面显示出比CL测量更好的诊断性能。
