{"id":223,"title":"Diagnostic performance of MRI and transvaginal ultrasound for urinary tract endometriosis: a systematic review and meta-analysis","title_zh":"经阴道超声与MRI诊断泌尿系子宫内膜异位症的诊断效能：系统评价与meta分析","url":"https://pubmed.ncbi.nlm.nih.gov/42988935","doi":"10.1007/s00404-026-08553-6","pmid":"42988935","journal":"Arch Gynecol Obstet","kind":"paper","lang":"en","published_at":"2026-08-10T00:00:00+00:00","fetched_at":"2026-11-08T03:44:00+00:00","authors":["Pitsillidi A","Vona L","Kyriakoulis K","Iliakis P","Stabile G","Noé G"],"primary_topic":"endometrium","topics":[{"slug":"endometrium","score":4.0,"hits":["endometriosis"]},{"slug":"ethics-policy","score":1.0,"hits":["guidelines"]}],"topic_score":4.0,"preference_score":0.0,"preference_labels":[],"llm_score":68.0,"final_score":68.0,"score_dims":{"novelty":55,"rigor":80,"impact":58,"relevance":55,"translation":70},"recommend_reason":"纳入36项研究、方法学规范，为泌尿系内异症的影像选择提供了分部位合并的敏感度/特异度数据，对术前评估与转诊决策有直接参考价值；但属诊断准确性证据的再整合，与ART实验室及胚胎环节关联有限。","keywords":["子宫内膜异位症","泌尿系子宫内膜异位症","经阴道超声","磁共振成像","诊断准确性","meta分析"],"selected":1,"story_id":448,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-uterus-pregnancy","source_name":"PubMed · 内膜/植入/早孕","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该系统评价与meta分析依据PRISMA 2020，检索PubMed、Embase和Scopus至2025年12月，纳入评估经阴道超声（TVUS）和/或MRI诊断泌尿系子宫内膜异位症（UTE）的诊断准确性研究共36项，以手术及（或不）病理所见为参考标准，采用双变量随机效应模型分别合并输尿管与膀胱病变的敏感度与特异度。结果：对输尿管病变，TVUS敏感度0.89、特异度1.00，MRI敏感度0.96、特异度1.00；对膀胱病变，TVUS敏感度0.70、MRI敏感度0.77，两者特异度均约1.00。异质性较大，尤其敏感度。结论：两法特异度均优，MRI对输尿管病变更敏感，膀胱病变敏感度中等，支持按部位选择互补影像策略并谨慎解读阴性结果。","summary":"OBJECTIVE: To compare the diagnostic accuracy of transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) for detecting urinary tract endometriosis (UTE), including ureteral and bladder involvement. METHODS: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. PubMed, Embase, and Scopus were searched from inception to December 2025 for diagnostic accuracy studies evaluating TVUS and/or MRI for UTE. Surgical findings, with or without histopathological confirmation, were used as the reference standard. Studies reporting sufficient data to construct 2 × 2 contingency tables were included. Pooled sensitivity and specificity with 95% confidence intervals (CI) were calculated using a bivariate random-effects model, with separate analyses for ureteral and bladder endometriosis. RESULTS: Thirty-six studies met the inclusion criteria. For ureteral endometriosis, TVUS demonstrated a pooled sensitivity of 0.89 (95% CI 0.65-0.97) and specificity of 1.00 (95% CI 0.97-1.00), while MRI showed a pooled sensitivity of 0.96 (95% CI 0.50-1.00) and specificity of 1.00 (95% CI 0.96-1.00). For bladder endometriosis, TVUS yielded a pooled sensitivity of 0.70 (95% CI 0.55-0.81) and specificity of 1.00 (95% CI 0.99-1.00), whereas MRI demonstrated a pooled sensitivity of 0.77 (95% CI 0.58-0.89) and specificity of 0.99 (95% CI 0.98-1.00). Substantial heterogeneity was observed, particularly for sensitivity estimates. CONCLUSION: TVUS and MRI show excellent specificity for diagnosing urinary tract endometriosis. MRI provides slightly higher sensitivity for ureteral disease, while both modalities demonstrate moderate sensitivity for bladder involvement. A complementary, site-specific imaging approach is, therefore, supported, with cautious interpretation of negative findings.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}