title: Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis.
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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Radiology, University Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: García-Blázquez
authors.forename: A
authors.initials: A
authors.lastname: Vicente-Bártulos
authors.forename: A
authors.initials: A
authors.lastname: Olavarria-Delgado
authors.forename: M N
authors.initials: MN
authors.lastname: Plana
authors.forename: D
authors.initials: D
authors.lastname: van der Winden
authors.forename: J
authors.initials: J
authors.lastname: Zamora
mesh_terms: D000208:Acute Disease; D000792:Angiography / Q000706:statistics & numerical data*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*