@misc{10481/64057,
year = {2020},
url = {http://hdl.handle.net/10481/64057},
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.},
abstract = {Tweetable abstract To investigate adnexal torsion, ultrasound is a
good first-line diagnostic test with a pooled sensitivity of 0.79 and
specificity of 0.76.},
publisher = {WILEY},
keywords = {Adnexa},
keywords = {Computed tomography},
keywords = {Doppler},
keywords = {Magnetic resonance imaging},
keywords = {Meta-analysis},
keywords = {Ovary},
keywords = {Test accuracy},
keywords = {Torsion},
keywords = {Ultrasound},
title = {Accuracy of imaging modalities for adnexal torsion: a systematic review and meta-analysis},
doi = {10.1111/1471-0528.16371},
author = {Wattar, B. and Saeed Khan, Khalid},
}