Objective To evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses. Methods The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data， and assessed the methodology quality. Meta-analysis were performed using the Metadisc 1.40 software. The acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Results Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously. Conclusion According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.
目的 探讨B超引导下穿刺置管引流技术在重症急性胰腺炎治疗中的应用价值。方法 36例重症急性胰腺炎患者均行腹腔穿刺置管引流，其中经皮肝胆管（胆囊）穿刺置管引流（PTCD）23例，腹膜后积液（脓肿）穿刺置管冲洗引流16例，配合常规内科治疗，取得满意效果。结果 所有患者穿刺置管过程顺利，均未出现与穿刺相关的并发症如气胸、血胸、腹腔内出血、穿刺部位感染等。所有患者在禁食、胃肠减压、抗生素、生长抑素、制酸、维持水电解质酸碱平衡及肠内外营养支持治疗的基础上辅以超声引导下穿刺置管引流，仅1例暴发性胰腺炎患者发生脓腔内大出血导致多器官衰竭而死亡，其余35例均治愈，无中转开腹手术，患者腹痛、腹胀、腹部压痛等主要症状和体征缓解时间为（4.4±1.3）d（1～7d），尿淀粉酶恢复正常时间为（3.1±1.5）d（2～8d）,住院时间为（23.4±7.3）d（16～55d）。结论 B超引导下穿刺置管引流术操作简单、创伤轻微，在重症急性胰腺炎治疗中有重要价值。