Diagnostic accuracy of computerized tomography (CT) angiography in detecting non-variceal gastrointestinal bleeding

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Tiziana Ciarambino1, Orazio V Giannico2, Giovanni Menna3

  • 1Hospital of Marcianise, ASL Caserta, Caserta, Italy - tiziana.ciarambino@gmail.com.

Minerva Gastroenterologica E Dietologica
|October 26, 2020
PubMed

Insights

Computerized tomography (CT) angiography demonstrates high accuracy in detecting non-variceal gastrointestinal bleeding (NVGIB). This imaging technique is valuable when endoscopy is unavailable for acute bleeding cases.

Area of Science:

  • Gastroenterology
  • Radiology
  • Medical Imaging

Background:

  • Gastrointestinal bleeding (GIB) management often involves endoscopy.
  • Non-variceal GIB (NVGIB) requires accurate diagnostic tools.
  • Computerized tomography (CT) angiography is a potential diagnostic modality.

Purpose of the Study:

  • To systematically review and evaluate the diagnostic accuracy of CT angiography for NVGIB.
  • To assess the sensitivity and specificity of CT angiography in detecting NVGIB.

Main Methods:

  • Systematic review of studies from 2009-2019.
  • Inclusion of adult patients with GIB, excluding variceal bleeding.
  • Bivariate random-effects meta-analysis to estimate pooled sensitivity, specificity, and SROC curve.
  • Univariate model to estimate pooled Diagnostic Odds Ratio (DOR) and heterogeneity.

Main Results:

  • Eleven studies met inclusion criteria.
  • Pooled sensitivity for CT angiography in detecting NVGIB was 85% (95% CI: 75%-92%).
  • Pooled specificity was 93% (95% CI: 89%-96%).
  • Pooled DOR was 94.35 (95% CI: 37.91-234.82).
  • Heterogeneity was not statistically significant (p=0.377).

Conclusions:

  • CT angiography exhibits good sensitivity and specificity for detecting NVGIB.
  • Consider CT angiography for suspected NVGIB, particularly when endoscopy is not readily available.
  • Useful in active bleeding scenarios with suggestive signs and symptoms.
Abstract

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