Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Department of Ultrasound, The First Hospital of Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, People's Republic of China.
Medicine (Baltimore). 2021 Dec 3;100(48):e27532. doi: 10.1097/MD.0000000000027532.
: There is still a debate on which imaging method is the best to diagnose cesarean scar pregnancy (CSP). Accordingly, this study aimed to analyze the diagnostic performance of magnetic resonance imaging (MRI) and ultrasonography (US) on the detection of CSP based on current evidence in the literature.
PubMed, Embase, Cochrane, Chinese Biomedical Documentation Service System, WanFang, and China National Knowledge Infrastructure databases were searched up to June 2020. The included studies were all comparisons of MRI and US in the diagnosis of CSP that adopted postoperative histological examination as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating characteristic curve (AUC) were calculated for MRI and US.
Thirteen studies were included, with a total sample size of 948 patients. The pooled sensitivity, specificity, PLR, NLR, and AUC of MRI in diagnosing CSP were 0.93 (95% CI, 0.91-0.95), 0.83 (95% CI, 0.75-0.89), 5.46 (95% CI, 3.70-8.05), 0.08 (95% CI, 0.06-0.11), and 0.96 (95% CI, 0.93-0.97), respectively; for US they were 0.84 (95% CI, 0.79-0.88), 0.73 (95% CI, 0.62-0.81), 3.06 (95% CI, 2.22-4.21), 0.23 (95% CI, 0.18-0.28), and 0.86 (95% CI, 0.83-0.89), respectively.
We found that both MRI and US effectively diagnosed CSP; however, MRI had a higher diagnostic performance in detecting CSP than US.
对于哪种影像学方法是诊断剖宫产瘢痕妊娠（CSP）的最佳方法，仍存在争议。因此，本研究旨在根据当前文献中的证据分析磁共振成像（MRI）和超声（US）在诊断 CSP 方面的诊断性能。
检索 PubMed、Embase、Cochrane、中国生物医学文献数据库、万方和中国知网数据库，检索时限截至 2020 年 6 月。纳入的研究均为 MRI 和 US 诊断 CSP 的比较，均采用术后组织学检查作为参考标准。计算 MRI 和 US 诊断 CSP 的汇总敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）和汇总受试者工作特征曲线下面积（AUC）。
共纳入 13 项研究，总样本量为 948 例患者。MRI 诊断 CSP 的汇总敏感性、特异性、PLR、NLR 和 AUC 分别为 0.93（95%CI，0.91-0.95）、0.83（95%CI，0.75-0.89）、5.46（95%CI，3.70-8.05）、0.08（95%CI，0.06-0.11）和 0.96（95%CI，0.93-0.97）；US 分别为 0.84（95%CI，0.79-0.88）、0.73（95%CI，0.62-0.81）、3.06（95%CI，2.22-4.21）、0.23（95%CI，0.18-0.28）和 0.86（95%CI，0.83-0.89）。
我们发现 MRI 和 US 均可有效诊断 CSP，但 MRI 在诊断 CSP 方面的诊断性能优于 US。
