Accuracy of transvaginal ultrasound for diagnosis of deep infiltrating endometriosis in the uterosacral ligaments: Systematic review and meta-analysis

Yuli Zhou, Zhou Y, Su Y, Youhuan Su, Huiyu Liu, Liu H, Huaiyu Wu, Wu H, Xu J, Jinfeng Xu, Fajin Dong
Journal of gynecology obstetrics and human reproduction · 2020 · vol. 50(3) , pp. 101953 · doi:10.1016/j.jogoh.2020.101953 · PMID:33148442 · W3093756215
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This systematic review and meta-analysis evaluated the accuracy of transvaginal ultrasound in diagnosing deep infiltrating endometriosis within the uterosacral ligaments.

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Abstract

ObjectivesTo review the diagnostic accuracy of transvaginal ultrasound (TVS) in the preoperative detection of uterosacral ligaments (USL) in patients with clinical suspicion of deep infiltrating endometriosis (DIE).MethodsExtensive searches were conducted in PubMed, EMBASE and Cochrane libraries to search studies published between January 1989 and September 2, 2019. The inclusion criteria were the preoperative assessment of USL endometriosis by TVS in patients with clinically suspected DIE, using laparoscopy and histological results as the reference standard. The assessment of research quality uses preferred reporting items, including the System Review and Meta Analysis (PRISMA) guidelines, as well as the quality assessment of diagnostic accuracy study 2 (QUADAS-2) tools.ResultsDuring our advanced search, 7562 studies were identified. Finally, 11 of which were recognized as qualified and incorporated into this study. The pooled sensitivity, specificity, positive probability ratio (LR+) and negative probability ratio(LR-) of TVS for detecting DIE in the USL were 65 %(95 %CI:43-83), 92 %(95 %CI:84-96), 7.80 (95 %CI:4.7-13.0) and 0.38(95 %CI:0.22-0.66), respectively. There was significant heterogeneity in sensitivity (I2: 97.40 %; Cochran Q, 385.09; P<0.001) and specificity (I2, 93.89 %; Cochran Q, 163.75; P < 0.001).ConclusionTVS provides an excellent comprehensive diagnostic performance for DIE of the USL. However, further research is required to improve the diagnostic quality.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Ultrasonography Adolescent Adult Endometriosis Female Humans Ligaments Ligaments Middle Aged Peritoneal Diseases Peritoneal Diseases Sacrum Sacrum Sensitivity and Specificity Ultrasonography Uterus Uterus Vagina

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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