Background: Differential diagnosis of ovarian masses can influence both treatment selection and prognosis of ovarian tumor patients. A comprehensive review was performed with respect to the diagnostic value of conventional ultrasonography, Doppler ultrasonography and contrast-enhanced ultrasonography (CEUS) in differentiating benign from malignant ovarian masses. Methods: Databases were searched for relevant articles. Retrieved studies were screened according to the inclusion criteria. Pooled statistics including specificity, sensitivity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), diagnostic odds ratio (DOR) and area under curve (AUC) were utilized to calculate the overall diagnostic value for each diagnostic approach. Results: Sixty-seven high quality articles were finally enrolled in the present meta-analysis. The sensitivity and specificity of conventional US were 0.92 and 0.86, respectively. The corresponding sensitivity and specificity of Doppler US were 0.93 and 0.85, respectively. Additionally, these figures for CEUS were 0.97 and 0.92, respectively. Finally, the AUC values for conventional US, Doppler US and CEUS were 0.95, 0.96 and 0.99, respectively. Conclusion: All of the three US-related imaging modalities have relatively high diagnostic value in distinguishing malignant tumors from benign ones in ovarian tumors.
Contrast-enhanced ultrasound for differential diagnosis of malignant and benign ovarian tumors: systematic review and meta-analysis
