Gynaecological Ultrasound in Emergency Medicine

Villalba, Martha; Lambert, Michael J.

doi:10.1002/9781119072874.ch13

Cited by 1 publication

(2 citation statements)

References 10 publications

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“…Certainly, several emergency departments now offer rapidaccess ultrasound to aid the diagnosis in women with nonspecific abdominal pain, which seems to optimise the diagnosis and management process. 28 Our findings depict relatively wide confidence intervals for the accuracy of ultrasound to diagnose AT. Therefore, clinicians should consider the diagnostic limitations of ultrasound, especially when faced with complex ovarian morphology such as very large cysts, complex masses or paediatric cases, 4 which might increase the rate of false-negative findings.…”

Section: Discussionmentioning

confidence: 68%

“…Our estimates support the role of ultrasound as a reliable first‐line diagnostic tool for AT. Certainly, several emergency departments now offer rapid‐access ultrasound to aid the diagnosis in women with non‐specific abdominal pain, which seems to optimise the diagnosis and management process 28 . Our findings depict relatively wide confidence intervals for the accuracy of ultrasound to diagnose AT.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Accuracy of imaging modalities for adnexal torsion: a systematic review and meta‐analysis

Wattar

Rimmer

Rogozińska

et al. 2020

BJOG

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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.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 78%