Obstetrics and Gynecology, University of Navarra Clinic, Pamplona, Spain.
Obstetrics and Gynecology, University Hospital Complex Badajoz, Spain.
Ultraschall Med. 2023 Jun;44(3):280-289. doi: 10.1055/a-1408-2292. Epub 2021 Mar 23.
To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting cervical infiltration by endometrial carcinoma using meta-analysis assessment.
An extensive search of papers comparing TVS and MRI for assessing cervical infiltration in endometrial cancer in the same set of patients was performed in Medline (Pubmed), Web of Science, and the Cochrane Database. Quality was assessed using QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies-2). Quantitative meta-analysis was performed.
Our extended search identified 12 articles that used both techniques in the same set of patients and were included in the meta-analysis. The risk of bias for most studies was high for patient selection and index tests in QUADAS-2. Overall, the pooled estimated sensitivity and specificity for diagnosing cervical infiltration in women with endometrial cancer were identical for both techniques [69 % (95 % CI, 51 %-82 %) and 93 % (95 % CI, 90 %-95 %) for TVS, and 69 % (95 % CI, 57 %-79 %) and 91 % (95 % CI, 90 %-95 %) for MRI, respectively]. No statistical differences were found when comparing both methods. Heterogeneity was high for sensitivity and moderate for specificity when analyzing TVS and moderate for both sensitivity and specificity in the case of MRI.
TVS and MRI showed very similar diagnostic performance for diagnosing cervical involvement in women with endometrial cancer.
采用荟萃分析评估比较经阴道超声（TVS）和磁共振成像（MRI）检测子宫内膜癌宫颈浸润的诊断准确性。
在 Medline（Pubmed）、Web of Science 和 Cochrane 数据库中广泛搜索比较 TVS 和 MRI 评估子宫内膜癌患者宫颈浸润的文献。使用 QUADAS-2 工具（诊断准确性研究的质量评估-2）评估质量。进行定量荟萃分析。
我们的扩展搜索确定了 12 篇在同一组患者中同时使用这两种技术的文章，并纳入荟萃分析。在 QUADAS-2 中，大多数研究的患者选择和指数测试的偏倚风险较高。总体而言，TVS 和 MRI 诊断子宫内膜癌患者宫颈浸润的汇总估计敏感性和特异性相同[69%（95%CI，51%-82%）和 93%（95%CI，90%-95%），分别用于 TVS 和 69%（95%CI，57%-79%）和 91%（95%CI，90%-95%）用于 MRI]。两种方法比较时未发现统计学差异。分析 TVS 时，敏感性的异质性较高，特异性的异质性中度，而分析 MRI 时，敏感性和特异性的异质性均为中度。
TVS 和 MRI 对诊断子宫内膜癌患者宫颈受累的诊断性能非常相似。
