Wang Wen-Huan, Zheng Chang-Bao, Gao Jin-Niao, Ren Shang-Shang, Nie Guo-Yan, Li Zhi-Qun
Department of Medical Imaging, Haikou Hospital of the Maternal and Child Health, Haikou, China.
Department of Medical Imaging, Hainan Cancer Hospital, Haikou, China.
Gland Surg. 2022 Feb;11(2):330-340. doi: 10.21037/gs-21-889.
With the increasing incidence of gynecological ovarian tumors, the differential diagnosis of benign and malignant ovarian tumors is of great significance for subsequent treatment. Currently, ovarian examinations commonly use computed tomography (CT) or magnetic resonance imaging (MRI). This study sought to compare the value of CT and MRI in differentiating between benign and malignant ovarian tumors.
The PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and Weipu databases were searched for published articles using the following terms "CT" or "Computed Tomography" or "MRI" or "Magnetic Resonance imaging" and "ovarian cancer" or "ovarian tumor" or "ovarian neoplasm" or "adnexal mass" or "adnexal lesion". The articles were screened and the data were extracted based on the inclusion and exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies-2 recommended by the Cochrane Collaboration was used to assess the methodological quality of the included studies, and the network meta-analysis was performed by Stata 15.0.
The results showed that the overall sensitivity and specificity of CT were 0.79 [95% confidence intervals (CI): 0.70-0.87] and 0.87 (95% CI: 0.80-0.92), respectively. The overall sensitivity and specificity of MRI were 0.94 (95% CI: 0.91-0.95) and 0.91 (95% CI: 0.90-0.93), respectively. The area under the curve of the CT and MRI summary receiver operating characteristics were 0.9016 and 0.9764, respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CT were 5.26 (95% CI: 2.78-9.93), 0.26 (95% CI: 0.13-0.50), and 22.19 (95% CI: 7.54-65.30), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of MRI were 8.69 (95% CI: 5.06-14.92), 0.07 (95% CI: 0.04-0.13), and 146.19 (95% CI: 68.88-310.24), respectively.
Compared to CT, MRI has a stronger ability to differentiate between benign and malignant ovarian tumors. It's a promising non-radiological imaging technique and a more favorable choice for patients with ovarian tumors. However, in the future, large-sample, multi-center prospective studies need to be conducted to compare the performance of MRI and CT in distinguishing between benign and malignant ovarian tumors.
随着妇科卵巢肿瘤发病率的不断上升，卵巢良恶性肿瘤的鉴别诊断对后续治疗具有重要意义。目前，卵巢检查常用计算机断层扫描（CT）或磁共振成像（MRI）。本研究旨在比较CT和MRI在鉴别卵巢良恶性肿瘤中的价值。
在PubMed、Cochrane对照试验中心注册库、Embase、Web of Science、中国知网、万方和维普数据库中检索已发表的文章，检索词为“CT”或“计算机断层扫描”或“MRI”或“磁共振成像”以及“卵巢癌”或“卵巢肿瘤”或“卵巢肿物”或“附件包块”或“附件病变”。根据纳入和排除标准对文章进行筛选并提取数据。采用Cochrane协作网推荐的诊断准确性研究质量评估-2来评估纳入研究的方法学质量，并使用Stata 15.0进行网状Meta分析。
结果显示，CT的总体敏感度和特异度分别为0.79[95%置信区间（CI）：0.70 - 0.87]和0.87（95%CI：0.80 - 0.92）。MRI的总体敏感度和特异度分别为0.94（95%CI：0.91 - 0.95）和0.91（95%CI：0.90 - 0.93）。CT和MRI汇总受试者工作特征曲线下面积分别为0.9016和0.9764。CT的阳性似然比、阴性似然比和诊断比值比分别为5.26（95%CI：2.78 - 9.93）、0.26（95%CI：0.13 - 0.50）和22.19（95%CI：7.54 - 65.30）。MRI的阳性似然比、阴性似然比和诊断比值比分别为8.69（95%CI：5.06 - 14.9）、0.07（95%CI：0.04 - 0.13）和146.19（95%CI：68.88 - 310.24）。
与CT相比，MRI鉴别卵巢良恶性肿瘤的能力更强。它是一种有前景的非放射成像技术，对于卵巢肿瘤患者是更有利的选择。然而，未来需要进行大样本、多中心前瞻性研究来比较MRI和CT在鉴别卵巢良恶性肿瘤方面的表现。
