title: Use of positive oral contrast agents in abdominopelvic computed tomography for blunt abdominal injury: meta-analysis and systematic review.
abstract: OBJECTIVE
  To determine whether positive oral contrast agents improve accuracy of abdominopelvic CT compared with no, neutral or negative oral contrast agent.
  
  
  METHODS
  Literature was searched for studies evaluating the diagnostic performance of abdominopelvic CT with positive oral contrast agents against imaging with no, neutral or negative oral contrast agent. Meta-analysis reviewed studies correlating CT findings of blunt abdominal injury with positive and without oral contrast agents against surgical, autopsy or clinical outcome allowing derivation of pooled sensitivity and specificity. Systematic review was performed on studies with common design and reference standard.
  
  
  RESULTS
  Thirty-two studies were divided into two groups. Group 1 comprised 15 studies comparing CT with positive and without oral contrast agents. Meta-analysis of five studies from group 1 provided no difference in sensitivity or specificity between CT with positive or without oral contrast agents. Group 2 comprised 17 studies comparing CT with positive and neutral or negative oral contrast agents. Systematic review of 12 studies from group 2 indicated that neutral or negative oral contrasts were as effective as positive oral contrast agents for bowel visualisation.
  
  
  CONCLUSIONS
  There is no difference in accuracy between CT performed with positive oral contrast agents or with no, neutral or negative oral contrast agent.
  
  
  CONCLUSIONS
  • There is no difference in the accuracy of CT with or without oral contrast agent. • There is no difference in the accuracy of CT with Gastrografin or water. • Omission of oral contrast, utilising neutral or negative oral contrast agent saves time, costs and decreases risk of aspiration.
authors.affiliation: Department of Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, Singapore, 308433. powerlee_1999@yahoo.com
authors.forename: Chau Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Benjamin
authors.initials: B
authors.lastname: Haaland
authors.forename: Arul
authors.initials: A
authors.lastname: Earnest
authors.forename: Cher Heng
authors.initials: CH
authors.lastname: Tan
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000284:Administration, Oral; D001464:Barium / Q000737:chemistry; D003287:Contrast Media / Q000737:chemistry*; D003974:Diatrizoate Meglumine / Q000737:chemistry; D006801:Humans; D007455:Iodine / Q000737:chemistry; D011860:Radiography, Abdominal / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014867:Water / Q000737:chemistry; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D014867:Water; D001464:Barium; D003974:Diatrizoate Meglumine; D007455:Iodine