子宫平滑肌瘤与肉瘤的鉴别诊断具有挑战性。磁共振成像（MRI）是继超声后对子宫肿块评估的第二线诊断方法。为评估MRI在子宫平滑肌瘤和肉瘤鉴别诊断中的准确性，我们进行了系统性综述和荟萃分析，检索了从成立至2023年6月的五个电子数据库。纳入所有报道术后无偏见组织学诊断为子宫平滑肌瘤或子宫肉瘤，并包含术前MRI评估子宫肿块的同行评审的观察性研究或随机临床试验。根据个体和汇总估计值计算MRI鉴别子宫平滑肌瘤和肉瘤的敏感性、特异性、阳性和阴性似然比、诊断比值和受试者操作特征曲线下的面积，并提供95％的置信区间（CI）。纳入了2495位妇女（2253位子宫平滑肌瘤和179位子宫肉瘤）的8项研究。MRI显示的汇总敏感性为0.90（95％CI 0.84-0.94），特异性为0.96（95％CI 0.96-0.97），阳性似然比为13.55（95％CI 6.20-29.61），阴性似然比为0.08（95％CI 0.02-0.32），诊断比值为175.13（95％CI 46.53-659.09），面积下的受试者操作特征曲线为0.9759。MRI在子宫平滑肌瘤和肉瘤的鉴别诊断中具有较高的诊断准确性。 © 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Differential diagnosis between uterine leiomyomas and sarcomas is challenging. Magnetic resonance imaging (MRI) represents the second-line diagnostic method after ultrasound for the assessment of uterine masses.To assess the accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas.A systematic review and meta-analysis was performed searching five electronic databases from their inception to June 2023.All peer-reviewed observational or randomized clinical trials that reported an unbiased postoperative histologic diagnosis of uterine leiomyoma or uterine sarcoma, which also comprehended a preoperative MRI evaluation of the uterine mass.Sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve on summary receiver operating characteristic of MRI in differentiating uterine leiomyomas and sarcomas were calculated as individual and pooled estimates, with 95% confidence intervals (CI).Eight studies with 2495 women (2253 with uterine leiomyomas and 179 with uterine sarcomas), were included. MRI showed pooled sensitivity of 0.90 (95% CI 0.84-0.94), specificity of 0.96 (95% CI 0.96-0.97), positive likelihood ratio of 13.55 (95% CI 6.20-29.61), negative likelihood ratio of 0.08 (95% CI 0.02-0.32), diagnostic odds ratio of 175.13 (95% CI 46.53-659.09), and area under the curve of 0.9759.MRI has a high diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas.© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.