Magnetic Resonance Imaging in Female Pelvic Masses：A Meta-Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TANG Jing ^1,2 , HUANG Zixing ¹ , SONG Bin. ¹

1. Department of Radiology， West China Hospital， Sichuan University， Chengdu 610041, Sichuan Province，China;;
2. Depatment of Gynecology and Obstetrics， West China Second Hospital， Sichuan University， Chengdu 610041， Sichuan Province， China;

Corresponding author：

Keywords：

Magnetic resonance imaging; Ultrasound; Female pelvic masses; Meta-analysis; Case-control study

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Objective 　To evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses.
Methods 　The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data， and assessed the methodology quality. Meta-analysis were performed using the Metadisc 1.40 software. The acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity.
Results 　Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously.
Conclusion 　According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.

Citation： TANG Jing,HUANG Zixing,SONG Bin.. Magnetic Resonance Imaging in Female Pelvic Masses：A Meta-Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 335-340. doi: Copy

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8.	Yamashita Y， Torashima M， Hatanaka Y， et al. Adnexal masses：accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging [J]. Radiology， 1995，194(2)：557-565.
9.	Van Vierzen PB， Massuger LF， Ruys SH， et al. Borderline ovarian malignancy： ultrasound and fast dynamic MR findings [J]. Eur J Radiol， 1998， 28(2)：136-142.
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11.	Fischerova D， Cibula D， Stenhova H， et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer [J]. Int J Gynecol Cancer， 2008， 18(4)：766-772.
12.	Sohaib SA， Mills TD， Sahdev A， et al. The role of magnetic resonance imaging and ultrasound in patients with adnexal masses [J]. Clin Radiol， 2005， 60(3)：340-348.
13.	傅加平，杜立新，梁碧玲. MRI 对女性盆腔肿块的诊断价值的探讨 [J]. 实用放射学杂志， 1997， 13(8)：461-465.
14.	Grab D， Flock F， Stöhr I， et al. Classification of asymptomatic adnexal masses by ultrasound, magnetic resonance imaging, and positron emission tomography [J]. Gynecol Oncol， 2000， 77(3)：454-459.
15.	Joshi M， Ganesan K, Munshi HN， et al. Ultrasound of adnexal masses [J]. Semin Ultrasound CT MRI， 2008，29(2)：72-97.

1. Pencer JA， Ghattamaneni S. MR imaging of the sonographically in determinate adnexal mass [J]. Radiology， 2010， 256(3)：677-694.
2. Komatsu T， Konishi I， Mandai M， et al. Adnexal masses： transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure [J]. Radiology， 1996， 198(1)：109-115.
3. Dai SY， Hata K， Inubashiri E， et al. Does three-dimensional power Doppler ultrasound improve the diagnostic accuracy for the prediction of adnexal malignancy? [J]. Obstet Gynaecol Res，2008， 34(3)：364-370.
4. Sohaib SA， Sahdev A， Van Trappen P， et al. Characterization of adnexal mass lesions on MR imaging [J]. AJR Am J Roentgenol，2003， 180(5)：1297-1304.
5. Higgins JPT， Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[updated march 2011].2009 Available from www. cochrane-handbook. org.
6. Zamora J, Abraira V， Muriel A， et al. Meta-DiSc： a software for meta-analysis of test accuracy data [J]. BMC Med Res Methodol，Published online 2006 July 12. doi：10.1186/1471-2288-6-31.
7. Jain KA， Friedman DL， Pettinger TW， et al. Adnexal masses：comparison of specificity of endovaginal US and pelvic MR imaging [J]. Radiology， 1993， 186(3)：697-704.
8. Yamashita Y， Torashima M， Hatanaka Y， et al. Adnexal masses：accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging [J]. Radiology， 1995，194(2)：557-565.
9. Van Vierzen PB， Massuger LF， Ruys SH， et al. Borderline ovarian malignancy： ultrasound and fast dynamic MR findings [J]. Eur J Radiol， 1998， 28(2)：136-142.
10. Huber S， Medl M， Baumann L， et al. Value of ultrasound and magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses [J]. Anticancer Res， 2002， 22(4)：2501-2507.
11. Fischerova D， Cibula D， Stenhova H， et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer [J]. Int J Gynecol Cancer， 2008， 18(4)：766-772.
12. Sohaib SA， Mills TD， Sahdev A， et al. The role of magnetic resonance imaging and ultrasound in patients with adnexal masses [J]. Clin Radiol， 2005， 60(3)：340-348.
13. 傅加平，杜立新，梁碧玲. MRI 对女性盆腔肿块的诊断价值的探讨 [J]. 实用放射学杂志， 1997， 13(8)：461-465.
14. Grab D， Flock F， Stöhr I， et al. Classification of asymptomatic adnexal masses by ultrasound, magnetic resonance imaging, and positron emission tomography [J]. Gynecol Oncol， 2000， 77(3)：454-459.
15. Joshi M， Ganesan K, Munshi HN， et al. Ultrasound of adnexal masses [J]. Semin Ultrasound CT MRI， 2008，29(2)：72-97.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Magnetic Resonance Imaging in Female Pelvic Masses：A Meta-Analysis

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