Diagnostic efficacy of 3-D hysterosalpingo-contrast sonography in the detection of tubal occlusion: Systematic meta-analysis.

Abstract

Evaluation of tubal status is critical in the diagnostic work-up of infertile women. The purpose of this study was to explore the diagnostic efficacy of three-dimensional hysterosalpingo-contrast sonography (3-D HyCoSy) for tubal occlusion. MedLine, Embase, Cochrane Library, ScienceDirect, CNKI, Chinese VIP Database, Chinese Wanfang Database and Chinese Biomedicine Database were searched for relevant trials published from June 1994 to August 2013. Meta-DiSc (version 1.4) was used for the meta-analysis. Diagnostic accuracy was determined by pooled estimates of sensitivity and specificity, as well as area under the curve (AUC) and the pooled diagnostic accuracy (Q*) derived from a summary receiver operating characteristic analysis. The heterogeneity test was done using the Cochran Q statistic and the I(2) statistic. Significant difference was defined as P < 0.10 (Q-statistic) or I(2) > 50% (I(2) -statistic) and a random effect model was used to pool data, otherwise the fixed effects model was used. A total of 11 studies (1037 Fallopian tubes) were included in this meta-analysis. The pooled estimates for diagnostic efficacy of 3-D HyCoSy had a sensitivity of 0.92 (95%CI: 0.89-0.94) and specificity of 0.95 (95%CI: 0.93-0.96). AUC and Q* were 0.976 and 0.929, respectively, but there was significant heterogeneity in sensitivity across the included studies. 3-D HyCoSy had good diagnostic performance in the detection of tubal occlusion.