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The role of diagnostic magnetic resonance hysterosalpingography in the evaluation of fallopian tubal occlusion of female infertility: A meta-analysis

  • Yun-zhi Li
    Affiliations
    Department of Radiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China

    First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
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  • Jie Qiu
    Affiliations
    Department of Radiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
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  • Bin Ma
    Affiliations
    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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  • Tian-gang Li
    Affiliations
    Department of Radiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
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  • Bin Yi
    Affiliations
    Department of Radiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
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  • Ya-guang Hu
    Affiliations
    Department of Radiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
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  • Author Footnotes
    1 Jun-qiang Lei, Ke-hu Yang contributed equally to this research.
    Jun-qiang Lei
    Correspondence
    Correspondence to: J.Q. Lei, First Clinical Medical College of Lanzhou University, No. 1, Dong gang West Road, Cheng guan District, Lanzhou, Gansu 730000, China.
    Footnotes
    1 Jun-qiang Lei, Ke-hu Yang contributed equally to this research.
    Affiliations
    First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
    Search for articles by this author
  • Author Footnotes
    1 Jun-qiang Lei, Ke-hu Yang contributed equally to this research.
    Ke-hu Yang
    Correspondence
    Corresponding author.
    Footnotes
    1 Jun-qiang Lei, Ke-hu Yang contributed equally to this research.
    Affiliations
    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
    Search for articles by this author
  • Author Footnotes
    1 Jun-qiang Lei, Ke-hu Yang contributed equally to this research.
Published:November 05, 2020DOI:https://doi.org/10.1016/j.clinimag.2020.11.001

      Highlights

      • This meta-analysis indicated that magnetic resonance hysterosalpingography (MR-HSG) had high sensitivity and specificity relative to the imaging standard X-HSG for fallopian tubal occlusion in the context of female infertility.
      • Both the viscosity of contrast agent and the test order affected the accuracy of MR-HSG for evaluating tubal occlusion.
      • Blind method application, thickness, magnetic intensity and interval between X-HSG and MR-HSG may affect the results of MR-HSG.

      Abstract

      Objective

      To evaluate the diagnostic performance of magnetic resonance hysterosalpingography for fallopian tubal occlusion in the context of female infertility when compared to the diagnostic performance of conditional X-ray hysterosalpingography.

      Methods

      PubMed, EMBASE, Web of Science, EBSCO, Cochrane Library database, Scopus were searched for studies in which magnetic resonance hysterosalpingography and X-ray hysterosalpingography were used as diagnostic tools for tubal occlusion assessment; databases were searched through April 2020. Two researchers conducted study inclusion assessment, data extraction, a systematic review, and pooled meta-analysis independently. Stata 15.1 software was used to analyze the pooled sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios, and the area under the summary receiver-operating characteristic curve of magnetic resonance hysterosalpingography.

      Results

      A total of five studies involving 101 patients and 198 fallopian tubes were finally included. Compared with the conditional X-ray hysterosalpingography (the imaging gold standard), the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the curve of magnetic resonance hysterosalpingography for tubal occlusion were 0.91 (95% CI: 0.48–0.99), 1.00 (95% CI: 0.87–1.00), 230.47 (95% CI: 6.79–7824.72), 0.09 (95% CI: 0.01–0.80), 2676.10 (95% CI: 61.35–120,000), and 1.00 (95% CI: 0.99–1.00), respectively. Subgroup analyses revealed that viscosity of contrast agent (P = 0.024) and test order (P = 0.036) affected the accuracy of MR-HSG to evaluate tubal occlusion.

      Conclusions

      Our meta-analysis indicated magnetic resonance hysterosalpingography may serve as an alternative for further evaluation of fallopian tubal occlusion of female infertility.

      Keywords

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