目的:本系统综述和荟萃分析的目的是评估经阴道超声(TVS)滑动征在检测怀疑子宫内膜异位症患者的道格拉斯闭塞和肠道受累方面的诊断准确性。以腹腔镜检查为参考标准。
方法:在PubMed/MEDLINE上进行了一项研究,该研究使用腹腔镜检查作为参考标准,评估滑动征在评估道格拉斯闭塞和/或肠道受累中的作用。WebofScience,CINAHL,科克伦图书馆,ClinicalTrials.gov和SCOPUS数据库。诊断准确性研究质量评估-2(QUADAS-2)用于评估研究质量。在STATA中使用MIDAS和METANDI命令进行分析。
结果:共发现334篇引文。八项研究被纳入分析,导致938和963名患者可用于分析道格拉斯闭塞和肠受累的滑动标志的诊断准确性,分别。道格拉斯闭塞的平均发生率为37%,肠受累的平均发生率为23%。汇总的估计灵敏度,特异性,正似然比,在TVS上检测道格拉斯消失囊的滑动标志的负似然比和诊断优势比为88%(95%CI,81-93%),94%(95%CI,91-96%),15.3(95%CI,10.2-22.9),0.12(95%CI,0.07-0.21)和123(95%CI,62-244),分别。检测道格拉斯闭塞囊的敏感性和特异性的异质性中等。汇总的估计灵敏度,特异性,正似然比,在TVS上滑动标志检测肠受累的阴性似然比和诊断比值比为81%(95%CI,64-91%),95%(95%CI,91-97%),16.0(95%CI,9.0-28.6),0.20(95%CI,0.10-0.40)和81(95%CI,34-191),分别。肠受累诊断准确性的荟萃分析的异质性很高。
结论:在疑似子宫内膜异位症的女性中,TVS的滑动征对预测道格拉斯闭塞和肠道受累具有良好的诊断性能。©2022作者由JohnWiley&SonsLtd代表国际妇产科超声学会出版的妇产科超声。
The aim of this systematic
review and meta-analysis was to evaluate the diagnostic accuracy of the sliding sign on transvaginal ultrasound (TVS) in detecting pouch of Douglas obliteration and bowel involvement in patients with suspected endometriosis, using laparoscopy as the reference standard.
A search for studies evaluating the role of the sliding sign in the assessment of pouch of Douglas obliteration and/or bowel involvement using laparoscopy as the reference standard published from January 2000 to October 2021 was performed in PubMed/MEDLINE, Web of Science, CINAHL, The Cochrane Library, ClinicalTrials.gov and SCOPUS databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of the studies. Analyses were performed using MIDAS and METANDI commands in STATA.
A total of 334 citations were identified. Eight studies were included in the analysis, resulting in 938 and 963 patients available for analysis of the diagnostic accuracy of the sliding sign for pouch of Douglas obliteration and bowel involvement, respectively. The mean prevalence of pouch of Douglas obliteration was 37% and the mean prevalence of bowel involvement was 23%. The pooled estimated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the sliding sign on TVS for detecting pouch of Douglas obliteration were 88% (95% CI, 81-93%), 94% (95% CI, 91-96%), 15.3 (95% CI, 10.2-22.9), 0.12 (95% CI, 0.07-0.21) and 123 (95% CI, 62-244), respectively. The heterogeneity was moderate for sensitivity and low for specificity for detecting pouch of Douglas obliteration. The pooled estimated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the sliding sign on TVS for detecting bowel involvement were 81% (95% CI, 64-91%), 95% (95% CI, 91-97%), 16.0 (95% CI, 9.0-28.6), 0.20 (95% CI, 0.10-0.40) and 81 (95% CI, 34-191), respectively. The heterogeneity for the meta-analysis of diagnostic accuracy for bowel involvement was high.
The sliding sign on TVS has good diagnostic performance for predicting pouch of Douglas obliteration and bowel involvement in women with suspected endometriosis. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.