Z Wang MD; J-Q Chen MD, PhD; J-L Liu MD; X-G Qin MD, PhD; Y Huang MD, PhD.
CT enterography in obscure gastrointestinal bleeding: A systematic review and meta-analysis
Version of Record online: 18 JAN 2013
© 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists
Journal of Medical Imaging and Radiation Oncology
Volume 57, Issue 3, pages 263–273, June 2013
How to Cite
Wang, Z., Chen, J.-q., Liu, J.-l., Qin, X.-g. and Huang, Y. (2013), CT enterography in obscure gastrointestinal bleeding: A systematic review and meta-analysis. Journal of Medical Imaging and Radiation Oncology, 57: 263–273. doi: 10.1111/1754-9485.12035
Conflict of interest: None declared.
- Issue online: 31 MAY 2013
- Version of Record online: 18 JAN 2013
- Manuscript Accepted: 28 NOV 2012
- Manuscript Received: 26 SEP 2012
- CT enterography;
- obscure gastrointestinal bleeding
The objective of this article is to provide a comprehensive and update overview of clinical application of CT enterography (CTE) in the evaluation of obscure gastrointestinal bleeding (OGIB). We performed a systematic review of relevant literatures in PubMed, EMBASE and The Cochrane Library and pooled the yield of CTE and the incremental yield (IY) of CTE over an alternate modality. A total of 18 studies (n = 660) reported the yield of CTE in evaluating OGIB and the pooled yield was 40% (95% confidence interval (CI): 33–49%). Seven studies (n = 279) compared the yield of CTE with capsule endoscopy (CE). The yield for CTE and CE for all findings was 34% and 53%, respectively (IY = −19%, 95% CI = −34% to −4%). When considering the types of identified lesions, the yield was significantly different for vascular and inflammatory lesions but not significantly different for neoplastic or other lesions. Two studies (n = 63) compared the yield of CTE with double-balloon enteroscopy (DBE). The yield for CTE and DBE was 38% and 78%, respectively (IY = −40%, 95% CI = −55% to −25%). Three studies (n = 49) compared the yield of CTE with digital subtraction angiography. The yield for CTE and digital subtraction angiography was 64% and 60%, respectively (IY = 4%, 95% CI = −40% to 47%). CTE is an excellent diagnostic tool in patients with OGIB. It may play a complementary role to CE and can be used as a triage tool prior to DBE in evaluating OGIB.