Evaluation of the diagnostic value of multi-slice spiral CT in acute mesenteric ischemic diseases: a meta-analysis of randomized controlled trials.

Abstract

OBJECTIVE\nThis study aimed to investigate the diagnostic value of multi-slice spiral CT (MSCT) in acute mesenteric ischemia.\n\n\nMATERIALS AND METHODS\nA systematic review was performed from the databases of PubMed, Web of Science and EMBASE by two researchers updated to July 1, 2018. The search terms included in the databases were mesenteric ischemia and multi-slice spiral computed tomography. A self-made data extraction form was used for data extraction, followed by quality assessment and heterogeneity testing of literature that met the requirements. Combined specificity and sensitivity were calculated and receiver operating characteristic (ROC) analyses were conducted. Meta-analysis was performed by STATA 12.0.\n\n\nRESULTS\nIn this meta-analysis, 231 patients with acute mesenteric ischemic disease and 651 patients in the control group in 8 independent randomized case-control studies were enrolled. Our meta-analysis showed that MSCT had significantly improved the diagnosis of acute mesenteric ischemia. Because of statistical heterogeneity in the study, we used the random effects model for analysis. The combined sensibility was 94% (95% CI: 83%-98%), and the combined specificity was 97% (95% CI: 93%-99%). The combined positive predictive value was 32.48 (95% CI: 13.53-77.98), the combined negative predictive value was 0.07 (95% CI: 0.02-0.18), and the combined diagnostic odds ratio was 6.21 (95% CI: 4.58-7.84). In terms of comprehensive diagnostic performance, the AUC was 0.99 (95% CI: 0.98-1.00) after plotting the SROC curve.\n\n\nCONCLUSIONS\nMSCT had a high sensitivity and specificity for the diagnosis of acute mesenteric ischemia. In addition, these studies with large samples and high quality in a multi-center hospital were needed to further confirm the reliability.