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Type: Journal article
Title: Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis
Author: Garcia-Blazquez, V.
Vicente-Bartulos, A.
Olavarria-Delgado, A.
Plana, M.
van der Winden, D.
Zamora, J.
Citation: European Radiology, 2013; 23(5):1181-1190
Publisher: Springer Verlag
Issue Date: 2013
ISSN: 0938-7994
Statement of
V. García-Blázquez, A. Vicente-Bártulos, A. Olavarria-Delgado, M. N. Plana, D. van der Winden, J. Zamora, for the EBM-Connect Collaboration
Abstract: OBJECTIVE: To assess the diagnostic accuracy of computed tomography (CT) angiography in the evaluation of patients with an episode of acute gastrointestinal haemorrhage. METHODS: Systematic review and meta-analysis to estimate pooled accuracy indices. A bivariate random effects model was adjusted to obtain a summary receiver-operating characteristic (sROC) curve and the corresponding area under the curve (AUC). RESULTS: Twenty-two studies were included and provided data on 672 patients (range of age 5-74) with a mean age of 65 years. The overall sensitivity of CT angiography for detecting active acute GI haemorrhage was 85.2 % (95 % CI 75.5 % to 91.5 %). The overall specificity of CT angiography was 92.1 % (95 % CI 76.7 % to 97.7 %). The likelihood ratios for positive and negative test results were 10.8 (95 % CI 3.4 to 34.4) and 0.16 (95 % CI 0.1 to 0.27) respectively, with an AUC of 0.935 (95 % CI 0.693 to 0.989). The sources of heterogeneity explored had no significant impact on diagnostic performance. CONCLUSIONS: CT shows high diagnostic accuracy and is an excellent diagnostic tool for detection and localising of intestinal bleeding sites. It is highly available, provides fast detection and localisation of the bleeding site, and is minimally invasive. KEY POINTS: • CT angiography is increasingly used for investigating severe gastrointestinal bleeding. • This systematic review and meta-analysis updates previous ones. • In patients with massive gastrointestinal bleeding, CT angiography/MDCT detects bleeding accurately. • CT angiography is useful in locating the bleeding site and determining appropriate treatment.
Keywords: Gastrointestinal haemorrhage; CT angiography; Sensitivity and specificity; Systematic review; Meta-analysis
Description: B. Mol is a member of the EBM-Connect Collaboration
Rights: © European Society of Radiology 2012
DOI: 10.1007/s00330-012-2721-x
Appears in Collections:Aurora harvest 7
Obstetrics and Gynaecology publications

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