目的:总结并比较经阴道超声(TVS)的准确性,3D-TVS,和超声宫腔造影(SHG)诊断宫腔粘连(IUA)。
方法:计算机搜索数据库,例如科学网,Medline,EMBASE,和PubMed通过超声收集IUA的诊断研究。检索时间包括从开始到2023年1月1日。两名研究人员独立筛选了文献,提取的信息,并使用RevMan5.3完成对纳入文献中偏倚风险的评估。采用Stata16.0和MetaDisc1.4软件对纳入研究进行Meta分析。
结果:共纳入13项研究。2D-TVS的分析结果为灵敏度(SEN):0.54(95%CI[0.28078]),特异性(SPE):0.96(95%CI[0.78,0.99]),和操作特征曲线下面积(AUC)(SROC):0.83(95%CI[0.80,0.86]);SEN,SPE,3D-TVS的AUC为:0.96(95%CI[0.90,0.98]),0.84(95%CI[0.68,0.93]),0.97(95%CI[0.95,0.98]);SEN,SPE,SHG的AUC为:0.74(95%CI[0.53,0.88]),0.97(95%CI[0.94,0.99]),0.95(95%CI[0.93,0.97])。
结论:当前结果表明,3D-TVS对IUA的诊断价值优于SHG,并且明显高于2D-TVS。然而,亚组分析仍然受到纳入研究数量的限制.为了更好地探讨超声在宫腔粘连中的应用,未来需要更多高质量的研究。
OBJECTIVE: To summarize and compare the accuracy of transvaginal ultrasound (TVS), 3D-TVS, and sonohysterography (SHG) for the diagnosis of intrauterine adhesions (IUA).
METHODS: The computer searches databases such as web of science, Medline, EMBASE, and PubMed collecting diagnostic studies of IUA via ultrasound. The retrieval time was included from inception to January 1, 2023. Two researchers independently screened the literature, extracted information, and used RevMan 5.3 to complete an assessment of the risk of bias in the included literature. Meta-analysis of included studies using Stata 16.0 and Meta Disc 1.4 software.
RESULTS: Thirteen studies were included. The analysis results of 2D-TVS are The sensitivity (SEN): 0.54 (95% CI [0.28078]), specificity (SPE): 0.96 (95% CI [0.78, 0.99]), and the area (AUC) under the operating characteristic curve (SROC): 0.83 (95% CI [0.80, 0.86]); the SEN, SPE, and AUC of 3D-TVS are: 0.96 (95% CI [0.90, 0.98]), 0.84 (95% CI [0.68, 0.93]), 0.97 (95% CI [0.95, 0.98]); and the SEN, SPE, and AUC of SHG are: 0.74 (95% CI [0.53, 0.88]), 0.97 (95% CI [0.94, 0.99]), 0.95 (95% CI [0.93, 0.97]).
CONCLUSIONS: The current results show that the diagnostic value of 3D-TVS for IUA is better than SHG and significantly higher than that of 2D-TVS. However, the analysis of subgroups is still limited by the number of included studies. In order to better explore the application of ultrasound in intrauterine adhesion, more high-quality studies are needed in the future.