经阴道超声与磁共振成像诊断子宫腺肌病的比较：系统评价和头对头荟萃分析。

Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis: A systematic review and head-to-head meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain.

Department of Obstetrics and Gynecology, Puerta de Mar University Hospital, Cadiz, Spain.

出版信息

Int J Gynaecol Obstet. 2023 May;161(2):397-405. doi: 10.1002/ijgo.14609. Epub 2022 Dec 11.

DOI:10.1002/ijgo.14609

PMID:36461921

Abstract

BACKGROUND

Transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) are used for the clinical diagnosis of adenomyosis.

OBJECTIVES

To compare the diagnostic accuracy of TVS and MRI for the diagnosis of adenomyosis.

SEARCH STRATEGY

A search of studies was performed in five databases comparing TVS and MRI for the diagnosis of adenomyosis from January 1990 to May 2022.

SELECTION CRITERIA

Studies were eligible if they reported on the use of TVS and MRI in the same set of patients. The reference standard must be pathology (hysterectomy).

DATA COLLECTION AND ANALYSIS

The quality of studies was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity of both techniques were estimated and compared.

MAIN RESULTS

Six studies comprising 595 women were included. The risk of bias of patient selection was high in three studies. The risk of bias for index tests and reference test was low. Pooled estimated sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for TVS were 75%, 81%, 3.9, and 0.31, respectively. These figures for MRI were 69%, 80%, 3.5, and 0.39, respectively. No statistically significant differences were found (p = 0.7509). Heterogeneity was high.

CONCLUSIONS

MRI and TVS have similar performances for the diagnosis of adenomyosis.

摘要

背景

经阴道超声（TVS）和磁共振成像（MRI）用于子宫腺肌病的临床诊断。

目的

比较 TVS 和 MRI 对子宫腺肌病的诊断准确性。

检索策略

对从 1990 年 1 月至 2022 年 5 月期间比较 TVS 和 MRI 用于诊断子宫腺肌病的五项数据库中的研究进行了检索。

选择标准

如果研究报告了 TVS 和 MRI 在同一组患者中的使用情况，则符合入选标准。参考标准必须是病理学（子宫切除术）。

数据收集和分析

使用 QUADAS-2 工具评估研究质量。估计并比较了这两种技术的汇总敏感性和特异性。

主要结果

共纳入 6 项研究，涉及 595 名女性。三项研究的患者选择偏倚风险较高。索引测试和参考测试的偏倚风险较低。TVS 的汇总估计敏感性、特异性、阳性似然比和阴性似然比分别为 75%、81%、3.9 和 0.31。MRI 的这些数值分别为 69%、80%、3.5 和 0.39。未发现统计学差异（p=0.7509）。存在高度异质性。