Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Aug 21, 2010; 16(31): 3957-3963
Published online Aug 21, 2010. doi: 10.3748/wjg.v16.i31.3957
Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: A meta-analysis
Lian-Ming Wu, Jian-Rong Xu, Yan Yin, Xin-Hua Qu
Lian-Ming Wu, Jian-Rong Xu, Yan Yin, Xin-Hua Qu, Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Author contributions: Wu LM, Xu JR, Yin Y and Qu XH designed the research; Wu LM and Xu JR performed the research; Wu LM, Xu JR and Yin Y analyzed the data; Wu LM, Xu JR and Qu XH wrote the paper.
Supported by Shanghai Leading Academic Discipline Project, No. S30203 and Shanghai Jiaotong University School of Medicine Leading Academic Discipline Project
Correspondence to: Jian-Rong Xu, MD, Professor, Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Pudong, Shanghai 200127, China. xujianr@yeah.net
Telephone: +86-21-58752345 Fax: +86-21-68738344
Received: March 1, 2010
Revised: April 27, 2010
Accepted: May 4, 2010
Published online: August 21, 2010
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 × 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 (χ2 = 12.5, P = 0.13) and (χ2 = 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.

Keywords: Angiography; Gastrointestinal hemorrhage; Meta-analysis; Sensitivity and specificity; Tomography