PDF(Pubmed)
Abstract：
Objectives: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative assessment of cervical invasion and to analyse the influence of different imaging protocols in patients with endometrial carcinoma. Methods: An extensive search of articles about MRI for assessing cervical invasion in patients with endometrial carcinoma was performed on PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials from January 2000 to July 2020. Two reviewers independently evaluated the methodological quality of each study by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Diagnostic accuracy results and additional useful information were extracted. The pooled estimation data was obtained by statistical analysis. Results: A total of 42 eligible studies were included in the meta-analysis. Significant evidence of heterogeneity was found for detecting cervical invasion (I2 = 74.1%, P = 0.00 for sensitivity and I2 = 56.2%, P = 0.00 for specificity). The pooled sensitivity and specificity of MRI were 0.58 and 0.95 respectively. The use of higher field strength (3.0 T) demonstrated higher pooled sensitivity (0.74). Using diffusion weighted imaging (DWI) alone presented higher pooled sensitivity (0.86) than using other sequences. The studies that used dynamic contrast-enhanced MRI (DCE-MRI) alone showed higher sensitivity (0.80) and specificity (0.96) than those that used T2-weighted imaging (T2WI) alone. Conclusions: MRI shows high specificity for detecting cervical infiltration in endometrial carcinoma. Using DWI or a 3.0-T device may improve the pooled sensitivity. DCE-MRI demonstrates higher pooled sensitivity and specificity than T2WI.
摘要：
目的:评价磁共振成像(MRI)术前评估宫颈侵犯的准确性,分析不同成像方案对子宫内膜癌的影响。方法：在PubMed上广泛搜索有关MRI评估子宫内膜癌患者宫颈侵犯的文章，Embase,WebofScience,科克伦图书馆,和2000年1月至2020年7月的临床试验。两名评审员通过使用诊断准确性研究质量评估-2（QUADAS-2）独立评估了每项研究的方法学质量。提取了诊断准确性结果和其他有用信息。通过统计分析获得合并的估计数据。结果：共有42项符合条件的研究纳入荟萃分析。发现异质性的重要证据用于检测宫颈浸润（I2=74.1％，灵敏度P=0.00，I2=56.2%，特异性P=0.00)。MRI的合并敏感性和特异性分别为0.58和0.95。使用更高的场强（3.0T）显示出更高的合并灵敏度（0.74）。单独使用扩散加权成像（DWI）比使用其他序列具有更高的合并灵敏度（0.86）。单独使用动态对比增强MRI（DCE-MRI）的研究显示出比单独使用T2加权成像（T2WI）的研究更高的灵敏度（0.80）和特异性（0.96）。结论:MRI对检测子宫内膜癌宫颈浸润有较高的特异性。使用DWI或3.0-T装置可以提高合并灵敏度。DCE-MRI显示出比T2WI更高的合并敏感性和特异性。
