不同影像学检查诊断卵巢肿瘤: Meta分析

目的 评价CEUS、增强MRI、功能性MRI和CT对卵巢肿瘤的诊断价值。方法 检索Embase、Medline 数据库，收集关于CEUS、增强MRI、功能性MRI及CT诊断卵巢肿瘤的文献资料。进行统计分析得到各组诊断性试验的合并敏感度、特异度及SROC曲线下面积（AUC）。采用Z检验比较组间独立诊断试验的诊断效能。结果 CEUS、增强MRI、功能性MRI和CT诊断卵巢恶性肿瘤的合并敏感度分别为0.89、0.93、0.83和0.88；合并特异度分别为0.91、0.90、0.79和0.91。四组影像学方法的AUC值分别为0.9619、0.9710、0.9090和0.9444。Z检验结果显示：CEUS、增强MRI、CT三者的诊断效能差异无统计学意义（P>0.05）；功能性MRI的诊断效能低于CEUS和增强MRI（P均<0.05）。结论 CEUS、增强MRI、功能性MRI和CT四种影像学方法对卵巢恶性肿瘤均具较高的诊断效能，对卵巢肿瘤的诊断各有优势和不足。

Diagnostic performance of different imaging tests for ovarian tumors: Meta-analysis

Objective To evaluate the overall diagnostic performance of CEUS, contrast-enhanced MRI (CE-MRI), functional MRI and CT for ovarian masses. Methods Embase and Medline databases were systematically searched for relevant articles on the diagnosis of ovarian masses using CEUS, CE-MRI, functional MRI or CT. Data were pooled to yield summary sensitivity, specificity and the area under the SROC curve (AUC). Z-value test was performed to determine whether the diagnostic value of two independent diagnostic tests had significant difference. Results The pooled sensitivity of CEUS, CE-MRI, functional MRI and CT was 0.89, 0.93, 0.83 and 0.88, and the pooled specificity was 0.91, 0.90, 0.79 and 0.91, as well as the AUC was 0.9619, 0.9710, 0.9090 and 0.9444, respectively. The results of Z-test revealed there were no significant differences in diagnostic performance between CEUS, CE-MRI and CT, and the diagnostic performance of functional MRI were significant inferior to that of CEUS or CE-MRI. Conclusion CEUS, CE-MRI, functional MRI and CT all have high diagnostic performance in diagnosis of malignant ovarian tumors, with their advantages and limitations.