Xu Ziwei, Li Yisheng, Wang Yingying, Wan Yiting, Chen Jing
Department of Gynecology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Med (Lausanne). 2025 Mar 17;12:1552185. doi: 10.3389/fmed.2025.1552185. eCollection 2025.
This meta-analysis aimed to assess the diagnostic efficacy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for the detection of rectosigmoid deep infiltrating endometriosis (DIE).
A thorough systematic review was performed by searching the PubMed and Embase databases for studies evaluating the diagnostic performance of TVS and MRI in rectosigmoid DIE, up until August 12, 2024. The DerSimonian and Laird approach was utilized to calculate sensitivity and specificity, with the Freeman-Tukey double arcsine transformation employed for data analysis. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
The meta-analysis encompassed 10 studies involving 1,604 patients. The findings revealed that TVS had an overall sensitivity of 0.85 (95% CI: 0.76-0.92) and specificity of 0.92 (95% CI: 0.85-0.98), while MRI demonstrated a sensitivity of 0.83 (95% CI: 0.73-0.92) and specificity of 0.95 (95% CI: 0.90-0.99). Statistical analysis indicated no significant differences in sensitivity ( = 0.86) or specificity ( = 0.50) between the two imaging techniques. Additionally, the funnel plot asymmetry test did not reveal significant publication bias for any outcomes (Egger's test: all > 0.05).
The meta-analysis reveals nearly equivalent diagnostic performance of TVS and MRI in detecting rectosigmoid DIE, with no statistical differences in sensitivity and specificity. However, high heterogeneity among studies highlights the need for further prospective research.
The protocol for this meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the ID: CRD42024559141, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559141.
本荟萃分析旨在评估经阴道超声（TVS）和磁共振成像（MRI）对直肠乙状结肠深部浸润型子宫内膜异位症（DIE）的诊断效能。
通过检索PubMed和Embase数据库，对截至2024年8月12日评估TVS和MRI在直肠乙状结肠DIE诊断性能的研究进行全面系统回顾。采用DerSimonian和Laird方法计算敏感性和特异性，并使用Freeman-Tukey双反正弦变换进行数据分析。使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。
该荟萃分析纳入了10项研究，涉及1604例患者。结果显示，TVS的总体敏感性为0.85（95%CI：0.76-0.92），特异性为0.92（95%CI：0.85-0.98），而MRI的敏感性为0.83（95%CI：0.73-0.92），特异性为0.95（95%CI：0.90-0.99）。统计分析表明，两种成像技术在敏感性（=0.86）或特异性（=0.50）方面无显著差异。此外，漏斗图不对称性检验未发现任何结局存在显著的发表偏倚（Egger检验：均>0.05）。
荟萃分析表明，TVS和MRI在检测直肠乙状结肠DIE方面的诊断性能几乎相当，敏感性和特异性无统计学差异。然而，研究之间的高度异质性凸显了进一步开展前瞻性研究的必要性。
本荟萃分析方案已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号：CRD42024559141，网址：https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559141 。
