Ultrasonography in the diagnosis of pelvic vein insufficiency, a systematic review and meta-analysis.

Apostolos G Pitoulias, Nefeli Andrioti Petropoulou, Vangelis Bontinis, Dimitrios A Chatzelas, Alkis Bontinis, Adriana Thano, Georgios A Pitoulias
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Abstract

Objective: To perform a systematic review and meta-analysis to investigate the efficacy of ultrasonography in the diagnosis of pelvic vein insufficiency (PVI).

Results: Seven studies comprised of 802 patients were included. Of these studies, 5 utilised transvaginal ultrasound (TVU), 1 utilised transabdominal ultrasound (TAU) and 1 utilised both ultrasounds as diagnostic tool .The overall pooled sensitivity and specificity was 0.96 and 0.84 respectively. The sensitivity and specificity for TVU were 0.96 and 0.86. The pooled sensitivities between studies employing a <7 mm cutoff in pelvic veins' diameter (PVD) and those employing a >7 mm threshold were 0.99 and 0.94 while the pooled specificities were 0.75 and 0.96 respectively.

Conclusion: The evidence supports the efficacy of ultrasonography in the diagnosis of PVI. A threshold of up to 6 mm in PVD yielded excellent sensitivity outcomes, but it is at the expense of specificity. This meta analysis suggests that a PVD threshold of 7 mm should be employed as a cutoff point in the diagnosis of PVI, displaying both excellent sensitivity and specificity outcomes.

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超声诊断盆腔静脉功能不全的系统回顾与荟萃分析。
目的:通过系统回顾和荟萃分析,探讨超声对盆腔静脉功能不全(PVI)的诊断价值。结果:纳入7项研究,共802例患者。在这些研究中,5项使用经阴道超声(TVU), 1项使用经腹部超声(TAU), 1项同时使用两种超声作为诊断工具。总的敏感性和特异性分别为0.96和0.84。TVU的敏感性和特异性分别为0.96和0.86。采用7毫米阈值的研究的综合敏感性分别为0.99和0.94,而综合特异性分别为0.75和0.96。结论:超声检查对PVI的诊断有一定的价值。PVD的阈值高达6mm产生了极好的灵敏度结果,但这是以牺牲特异性为代价的。该荟萃分析表明,PVD阈值7 mm可作为PVI诊断的截断点,显示出良好的敏感性和特异性结果。
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