Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.

<h4>Background</h4>To perform a systematic review and meta-analysis evaluating the diagnostic performance of computed tomography (CT) for small bowel obstruction (SBO), including diagnostic accuracy, ischemia, predicting surgical intervention, etiology and transition point.<h4>Meth...

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Main Authors: Zhengyan Li, Ling Zhang, Xijiao Liu, Fang Yuan, Bin Song
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226740&type=printable
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author Zhengyan Li
Ling Zhang
Xijiao Liu
Fang Yuan
Bin Song
author_facet Zhengyan Li
Ling Zhang
Xijiao Liu
Fang Yuan
Bin Song
author_sort Zhengyan Li
collection DOAJ
description <h4>Background</h4>To perform a systematic review and meta-analysis evaluating the diagnostic performance of computed tomography (CT) for small bowel obstruction (SBO), including diagnostic accuracy, ischemia, predicting surgical intervention, etiology and transition point.<h4>Methods</h4>PubMed/MEDLINE and related databases were searched for research articles published from their inception through August 2018. Findings were pooled using bivariate random-effects and summary receiver operating characteristic curve models. Meta-regression and subgroup analyses were performed to evaluate whether publication year, patient age, enhanced CT, slice thickness and pathogenesis affected classification accuracy.<h4>Results</h4>In total, 45 studies with a total of 4004 patients were included in the analysis. The pooled sensitivity and specificity of CT for SBO were 91% (95% confidence interval [CI]: 84%, 95%) and 89% (95% CI: 81%, 94%), respectively, and there were no differences in the subgroup analyses of age, publication year, enhanced CT and slice thickness. For ischemia, the pooled sensitivity and specificity was 82% (95% CI: 67%, 91%) and 92% (95% CI: 86%, 95%), respectively. No difference was found between enhanced and unenhanced CT based on subgroup analysis; however, high sensitivity was found in adhesive SBO compared with routine causes (96% vs. 78%, P = 0.03). The pooled sensitivity and specificity for predicting surgical intervention were 87% and 73%, respectively. The accuracy for etiology of adhesions, hernia and tumor was 95%, 70% and 82%, respectively. In addition, the pooled sensitivity and specificity for transition point was 92% and 77%, respectively.<h4>Conclusions</h4>CT has considerable accuracy in diagnosis of SBO, ischemia, predicting surgical intervention, etiology and transition point.
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spelling doaj-art-9c17ee1a67794504b0f29de9fd1214712025-08-20T02:17:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022674010.1371/journal.pone.0226740Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.Zhengyan LiLing ZhangXijiao LiuFang YuanBin Song<h4>Background</h4>To perform a systematic review and meta-analysis evaluating the diagnostic performance of computed tomography (CT) for small bowel obstruction (SBO), including diagnostic accuracy, ischemia, predicting surgical intervention, etiology and transition point.<h4>Methods</h4>PubMed/MEDLINE and related databases were searched for research articles published from their inception through August 2018. Findings were pooled using bivariate random-effects and summary receiver operating characteristic curve models. Meta-regression and subgroup analyses were performed to evaluate whether publication year, patient age, enhanced CT, slice thickness and pathogenesis affected classification accuracy.<h4>Results</h4>In total, 45 studies with a total of 4004 patients were included in the analysis. The pooled sensitivity and specificity of CT for SBO were 91% (95% confidence interval [CI]: 84%, 95%) and 89% (95% CI: 81%, 94%), respectively, and there were no differences in the subgroup analyses of age, publication year, enhanced CT and slice thickness. For ischemia, the pooled sensitivity and specificity was 82% (95% CI: 67%, 91%) and 92% (95% CI: 86%, 95%), respectively. No difference was found between enhanced and unenhanced CT based on subgroup analysis; however, high sensitivity was found in adhesive SBO compared with routine causes (96% vs. 78%, P = 0.03). The pooled sensitivity and specificity for predicting surgical intervention were 87% and 73%, respectively. The accuracy for etiology of adhesions, hernia and tumor was 95%, 70% and 82%, respectively. In addition, the pooled sensitivity and specificity for transition point was 92% and 77%, respectively.<h4>Conclusions</h4>CT has considerable accuracy in diagnosis of SBO, ischemia, predicting surgical intervention, etiology and transition point.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226740&type=printable
spellingShingle Zhengyan Li
Ling Zhang
Xijiao Liu
Fang Yuan
Bin Song
Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
PLoS ONE
title Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
title_full Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
title_fullStr Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
title_full_unstemmed Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
title_short Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis.
title_sort diagnostic utility of ct for small bowel obstruction systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226740&type=printable
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AT fangyuan diagnosticutilityofctforsmallbowelobstructionsystematicreviewandmetaanalysis
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