The Library
Accuracy of imaging modalities for adnexal torsion : a systematic review and meta-analysis
Tools
Wattar, Baihas, Rimmer, Michael, Rogozinska, Ewelina, Macmillian, Mark, Khan, Khalid S. and Al Wattar, Bassel H. (2021) Accuracy of imaging modalities for adnexal torsion : a systematic review and meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 128 (1). pp. 37-44. doi:10.1111/1471-0528.16371 ISSN 1470-0328.
|
PDF
WRAP-accuracy-imaging-modalities-adnexal-torsion-Al-Wattar-2020.pdf - Accepted Version - Requires a PDF viewer. Download (366Kb) | Preview |
Official URL: https://doi.org/10.1111/1471-0528.16371
Abstract
Background
Adnexal torsion (AT), a serious gynaecological emergency, often presents with non‐specific symptoms leading to delayed diagnosis.
Objective
To compare the test accuracy of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose AT.
Search strategy
We searched EMBASE, MEDLINE and Cochrane CENTRAL until December 2019.
Selection criteria
Studies reporting on the accuracy of any imaging modality (Index Test) in female patients (paediatric and adult) suspected of AT compared with surgical diagnosis and/or standard clinical/radiological follow‐up period until resolution of symptoms (Reference Standard).
Data collection and analysis
We assessed study quality using QUADAS‐2. We conducted test accuracy meta‐analysis using a univariate model or a hierarchical model.
Main results
We screened 3836 citations, included 18 studies (1654 women, 665 cases), and included 15 in the meta‐analyses. Ultrasound pooled sensitivity (n = 12, 1187 women) was 0.79 (95% CI 0.63–0.92) and specificity was 0.76 (95% CI 0.54–0.93), with negative and positive likelihood ratios of 0.29 (95% CI 0.13–0.66) and 4.35 (95% CI 2.03–9.32), respectively. Using Doppler with ultrasound (n = 7, 845 women) yielded similar sensitivity (0.80, 95% CI 0.67–0.93) and specificity (0.88, 95% CI 0.72–1.00). For MRI (n = 3, 99 women), the pooled sensitivity was 0.81 (95% CI 0.63–0.91) and specificity was 0.91 (95% CI 0.80–0.96). A meta‐analysis for CT was not possible with two case‐control studies and one cohort study (n = 3, 232 women). Its sensitivity range was 0.74–0.95 and specificity was 0.80–0.90.
Conclusions
Ultrasound has good performance as a first‐line diagnostic test for suspected AT. Magnetic resonance imaging could offer improved specificity to investigate complex ovarian morphology, but more evidence is needed.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Cell & Developmental Biology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
Library of Congress Subject Headings (LCSH): | Gynecology -- Diagnosis, Ultrasonic imaging, Generative organs, Female -- Ultrasonic imaging, Adnexa uteri -- Diseases | ||||||||
Journal or Publication Title: | BJOG: An International Journal of Obstetrics and Gynaecology | ||||||||
Publisher: | Wiley | ||||||||
ISSN: | 1470-0328 | ||||||||
Official Date: | January 2021 | ||||||||
Dates: |
|
||||||||
Volume: | 128 | ||||||||
Number: | 1 | ||||||||
Page Range: | pp. 37-44 | ||||||||
DOI: | 10.1111/1471-0528.16371 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | "This is the peer reviewed version of the following article:Wattar, B, Rimmer, M, Rogozinska, E, Macmillian, M, Khan, KS, Al Wattar, BH. Accuracy of imaging modalities for adnexal torsion: a systematic review and meta‐analysis. BJOG 2020; 00: 1– 8., which has been published in final form at https://doi.org/10.1111/1471-0528.16371. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 16 June 2020 | ||||||||
Date of first compliant Open Access: | 22 June 2021 | ||||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year