A systematic review and meta-analysis on transvaginal ultrasonography in the diagnosis of deep invasive endometriosis
Yuanhua Xiang, Gang Wang, Lingjuan Zhou, Qin Wang, Qinjie Yang
Abstract
BACKGROUND: The uterus is prone to many diseases, including endometriosis. Transvaginal ultrasonography (TVS) has become a frequently used detection method for deep invasive endometriosis (DIE). METHODS: The combinations of relevant keywords and medical topic title terms were searched in the databases of PubMed, Medline, and Embase, and the Cochrane Central Register of Controlled Trials (endometriosis) from their inception to June 2021. Based on the descriptive terms of endometriosis, deep infiltrating endometrium, heterotopia, deep endometriosis, ultrasound, and TVS, the full texts of the target articles were obtained and subjected to a manual search. Meta-analysis was performed using RevMan 5.3 software provided by the Cochrane collaboration. RESULTS: A total of 12 articles were included in this study, involving 1,707 patients overall. The sensitivity range was 0.57 to 0.98, and the specificity range was 0.87 to 1.00. The positive likelihood ratio (PLR) was 6.2282 [95% confidence interval (CI): 3.774 to 8.932]; the negative likelihood ratio (NLR) was 0.0664 (95% CI: 0.03 to 0.09); and the duration of remission was 1,174.7 (95% CI: 683.8 to 1,793.4). The sensitivity, specificity, PLR, NLR, and diagnostic odds ratio (DOR) of χ2 were 36.10 (P=0.021), 27.00 (P=0.035), 53.11 (P=0.001), 55.22 (P=0.001), and 63.89 (P=0.001), respectively, and the differences were statistically significant. DISCUSSION: A total of 12 articles were included in this meta-analysis, and the results were basically stable. Diagnosis with TVS showed high sensitivity (98%) and specificity (nearly 100%), indicating that it is a reasonable detection method for DIE, improving the disease status of patients.