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Meta-Analysis
. 2010 Aug 21;16(31):3957-63.
doi: 10.3748/wjg.v16.i31.3957.

Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis

Lian-Ming Wu  1 , Jian-Rong Xu, Yan Yin, Xin-Hua Qu
Affiliations
Meta-Analysis

Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis

Lian-Ming Wu et al. World J Gastroenterol. .

Abstract

Aim: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding.

Methods: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springerlink and Scopus, from January 1995 to December 2009, were searched for studies evaluating the accuracy of CT angiography in diagnosing acute GI bleeding. Studies were included if they compared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in the diagnosis of acute GI bleeding. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristic.

Results: A total of 9 studies with 198 patients were included in this meta-analysis. Data were used to form 2 x 2 tables. CT angiography showed pooled sensitivity of 89% (95% CI: 82%-94%) and specificity of 85% (95% CI: 74%-92%), without showing significant heterogeneity (chi(2) = 12.5, P = 0.13) and (chi(2) = 22.95, P = 0.003), respectively. Summary receiver operating characteristic analysis showed an area under the curve of 0.9297.

Conclusion: CT angiography is an accurate, cost-effective tool in the diagnosis of acute GI bleeding and can show the precise location of bleeding, thereby directing further management.

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Figures

Figure 1
Figure 1
Reports evaluated for inclusion in the meta-analysis. QUADAS: Quality Assessment of Diagnostic Accuracy Studies.
Figure 2
Figure 2
Forest plot of pooled sensitivity and specificity of computed tomography angiography in diagnosis of site of acute gastrointestinal bleeding. A: Sensitivity; B: Specificity.
Figure 3
Figure 3
Summary receiver-operating characteristic curve for computed tomography angiography in the diagnosis of site of acute gastrointestinal bleeding. SROC: Summary receiver-operating characteristic; AUC: Area under the curve.
See this image and copyright information in PMC

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