Yu-Jen Tseng1, Xiao-Qing Zeng1, Jie Chen1, Na Li1, Peng-Ju Xu2, Shi-Yao Chen3. 1. Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China. 2. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China. 3. Department of Gastroenterology, Endoscopy Center, Evidence-based Medicine Center, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: chen.shiyao@zs-hospital.sh.cn.
Abstract
AIMS: Gastroesophageal varices (GOV) is a common complication in patients with portal hypertension. We conducted a meta-analysis in attempt to evaluate the diagnostic accuracy of computed tomography (CT) as a noninvasive imaging tool for identifying GOV in reference to esophagogastroduodenoscopy (EGD). METHODS: A systemic literature search of multiple databases were conducted to identify articles that investigated the diagnostic performance of CT for GOV, while employing EGD as reference standard. A 2×2 table was conducted according to the available published data for both esophageal varices (EV) and gastric varices (GV) as individual subgroups. The following indices were calculated: pooled sensitivity and specificity, positive and negative likelihood ratio, diagnostic odds ratio, and area under receiver operating characteristics. All statistical analyses were conducted via STATA13.0 and RevMan5.3. RESULTS: A total of 11 studies were included in this meta-analysis, 10 articles evaluated the diagnostic accuracy of CT for EV (807 subjects) and 7 articles for GV (583 subjects). The pooled sensitivity and specificity for identifying EV were 0.896 (95% CI, 0.841-0.934) and 0.723 (95% CI, 0.644-0.791), respectively, with an AUROC of 0.86. The pooled sensitivity and specificity for identifying GV were 0.955 (95% CI, 0.903-0.980) and 0.658 (95% CI, 0.433-0.829), respectively, with an AUROC of 0.95. A subgroup analysis suggested varying CT technology could serve as a potential source of heterogeneity between included studies. A Deek's funnel plot indicated a low probability for publication bias. CONCLUSION: Computed tomography could potentially replace EGD as a primary screening tool for diagnosing GOV, however results should be interpreted with caution given its suboptimal specificity.
AIMS: Gastroesophageal varices (GOV) is a common complication in patients with portal hypertension. We conducted a meta-analysis in attempt to evaluate the diagnostic accuracy of computed tomography (CT) as a noninvasive imaging tool for identifying GOV in reference to esophagogastroduodenoscopy (EGD). METHODS: A systemic literature search of multiple databases were conducted to identify articles that investigated the diagnostic performance of CT for GOV, while employing EGD as reference standard. A 2×2 table was conducted according to the available published data for both esophageal varices (EV) and gastric varices (GV) as individual subgroups. The following indices were calculated: pooled sensitivity and specificity, positive and negative likelihood ratio, diagnostic odds ratio, and area under receiver operating characteristics. All statistical analyses were conducted via STATA13.0 and RevMan5.3. RESULTS: A total of 11 studies were included in this meta-analysis, 10 articles evaluated the diagnostic accuracy of CT for EV (807 subjects) and 7 articles for GV (583 subjects). The pooled sensitivity and specificity for identifying EV were 0.896 (95% CI, 0.841-0.934) and 0.723 (95% CI, 0.644-0.791), respectively, with an AUROC of 0.86. The pooled sensitivity and specificity for identifying GV were 0.955 (95% CI, 0.903-0.980) and 0.658 (95% CI, 0.433-0.829), respectively, with an AUROC of 0.95. A subgroup analysis suggested varying CT technology could serve as a potential source of heterogeneity between included studies. A Deek's funnel plot indicated a low probability for publication bias. CONCLUSION: Computed tomography could potentially replace EGD as a primary screening tool for diagnosing GOV, however results should be interpreted with caution given its suboptimal specificity.
Authors: Lee M Bass; Benjamin L Shneider; Lisa Henn; Nathan P Goodrich; John C Magee Journal: J Pediatr Gastroenterol Nutr Date: 2019-06 Impact factor: 2.839
Authors: D Jothimani; S Danielraj; B Nallathambi; B Pandurangan; S Kalyanasundaram; K Subbiah; H Ramachandran; R Venugopal; D Dhas; M Rela Journal: Clin Radiol Date: 2021-07-11 Impact factor: 2.350