Document Detail

Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis.
MedLine Citation:
PMID:  23192375     Owner:  NLM     Status:  MEDLINE    
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.
V García-Blázquez; A Vicente-Bártulos; A Olavarria-Delgado; M N Plana; D van der Winden; J Zamora;
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2012-11-29
Journal Detail:
Title:  European radiology     Volume:  23     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-11     Completed Date:  2013-09-30     Revised Date:  2013-11-04    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1181-90     Citation Subset:  IM    
Department of Radiology, University Hospital Ramón y Cajal, Madrid, Spain.
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MeSH Terms
Acute Disease
Angiography / statistics & numerical data*
Gastrointestinal Hemorrhage / radiography*
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Tomography, X-Ray Computed / statistics & numerical data*
Grant Support
//Canadian Institutes of Health Research
L Mignini / ; P von Dadelszen / ; L Magee / ; D Sawchuck / ; E Gao / ; B W Mol / ; K Oude Rengerink / ; J Zamora / ; C Fox / ; J Daniels / ; K S Khan / ; S Thangaratinam / ; C Meads /

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