Use of a saline chaser in abdominal computed tomography: a systematic review.
OBJECTIVE
To perform a systematic review of the literature regarding the use of a saline chaser in abdominal computed tomography (CT).


METHODS
The MEDLINE database was searched from 1966 to March 2007. Studies were included if they compared the magnitude of contrast enhancement with and without a saline chaser in CT and reported CT contrast enhancement values of the liver, portal vein, or abdominal aorta. For randomized controlled trials (RCTs) comparing the same dose of contrast material with and without a saline chaser, mean differences in the magnitude of contrast enhancement were pooled by using a fixed-effects model.


RESULTS
Seventeen studies met the inclusion criteria. Three RCTs using clinical images were included in the meta-analysis. The mean differences in contrast enhancement of the liver, portal vein, and aorta were -0.4 (95% CI, -2.4 to 1.7), 7.4 (95% CI, 1.3 to 14), and 11 (95% CI, -5.3 to 27), respectively. Three RCTs using a time-density analysis were included in the meta-analysis. The mean differences in peak contrast enhancement of the liver, portal vein, and aorta were 8.2 (95% CI, 4.2 to 12), 28 (95% CI, 16 to 40), and 15 (95% CI, 0.3 to 30), respectively.


CONCLUSIONS
In clinical images, a saline chaser did not improve contrast enhancement of the liver. In time-density analysis, however, a saline chaser improved peak contrast enhancement of the liver.
Takao
Hidemasa
H
Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. takaoh-tky@umin.ac.jp
Nojo
Takeshi
T
Ohtomo
Kuni
K
D000284:Administration, Oral; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods*; D011860:Radiography, Abdominal / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
D012965:Sodium Chloride