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Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis
Lian-Ming Wu1, Jian-Rong Xu, Yan Yin
1Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630 Dongfang Road, Pudong, Shanghai, China. xujianr@yeah.net.
Insights
Computed tomography (CT) angiography accurately diagnoses acute gastrointestinal (GI) bleeding. This imaging technique precisely locates bleeding, guiding effective patient management.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute gastrointestinal (GI) bleeding presents a significant diagnostic challenge.
- Accurate and timely diagnosis is crucial for effective patient management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of computed tomography (CT) angiography for acute GI bleeding.
- To synthesize evidence from multiple studies on CT angiography's performance.
Main Methods:
- A systematic literature search was conducted across major databases (MEDLINE, EMBASE, etc.) from 1995 to 2009.
- Meta-analysis methods were employed to pool sensitivity and specificity data.
- Studies were included if they compared CT angiography to established reference standards (endoscopy, colonoscopy, surgery).
Main Results:
- The meta-analysis included 9 studies with 198 patients.
- CT angiography demonstrated a pooled sensitivity of 89% and specificity of 85%.
- Summary receiver operating characteristic analysis yielded an area under the curve of 0.9297, indicating high diagnostic performance.
Conclusions:
- CT angiography is a highly accurate tool for diagnosing acute GI bleeding.
- Its ability to precisely locate the bleeding source aids in directing subsequent clinical management.
- CT angiography is considered a cost-effective diagnostic option.
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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