This meta-analysis evaluated the diagnostic value of ultrasonic elastography in detecting placental stiffness in the diagnosis of preeclampsia (PE). A systematic search was conducted in the EMBASE, Web of Science, Cochrane Library, Scopus database, and PubMed databases to identify studies published before June 2023 using ultrasonic elastography to diagnose PE. The sensitivity, specificity, and diagnostic odds ratio of ultrasonic elastography for diagnosing PE were calculated, and a summary receiver operating characteristic curve model was constructed. The degree of heterogeneity was estimated using the I2 statistic, and a meta-regression analysis was performed to explore its sources. A protocol was determined previously (PROSPERO: CRD42023443646). We included 1188 participants from 11 studies, including 190 patients with PE and 998 patients without PE as controls. Overall sensitivity and specificity of ultrasonic elastography in detecting placental stiffness for the diagnosis of PE were 89% (95% CI: 85-93) and 74% (95% CI: 51-89), respectively. The I2 values for sensitivity and specificity were 59% (95% CI: 29-89) and 96% (95% CI: 95-98), respectively. The area under the receiver operating characteristic curve was 0.90 (95% CI: 0.87-0.92). The meta-regression analysis showed no significant heterogeneity. Ultrasonic elastography exhibits good diagnostic accuracy for detecting placental stiffness and can serve as a non-invasive tool for differentially diagnosing PE.
Keywords: elastography; non-invasive tool; placental stiffness; ultrasonography.