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Use of a saline chaser in abdominal computed tomography: a systematic review

  • Hidemasa Takao
    Correspondence
    Corresponding author. Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Tel.: +81 3 5800 8666; fax: +81 3 5800 8935.
    Affiliations
    Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
    Search for articles by this author
  • Takeshi Nojo
    Affiliations
    Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Yosidakonoe-cho, Sakyo-Ku, Kyoto, Japan
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  • Kuni Ohtomo
    Affiliations
    Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
    Search for articles by this author

      Abstract

      Purpose

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

      Materials and 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.

      Conclusion

      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.

      Keywords

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