Use of Contrast-Enhanced Ultrasound for Confirmation of Central Venous Catheter Placement: Systematic Review and Meta-analysis

J Ultrasound Med. 2017 Dec;36(12):2503-2510. doi: 10.1002/jum.14296. Epub 2017 Jun 29.


Objectives: The purpose of this meta-analysis was to determine the sensitivity, specificity, and positive and negative predictive values of contrast-enhanced ultrasound (US) for confirming the tip location and placement of central venous catheters in adult patients.

Methods: A systematic review was performed using electronic databases, including MEDLINE,, Cochrane, Embase, PubMed, and Scopus. Inclusion criteria were studies conducted on adult patients receiving an internal jugular or a subclavian central venous catheter in the emergency department or intensive care unit. Furthermore, the catheter tip location had to be checked with the use of the agitated saline contrast-enhanced US technique.

Results: A total of 2245 articles were screened by title and abstract. Seventeen articles were retrieved and assessed for the predefined inclusion criteria. Four articles and 1 abstract were used in the final analysis. Contrast-enhanced US showed pooled sensitivity of 72% (95% confidence interval, 44%-91%), pooled specificity of 100% (95% confidence interval, 99%-100%), a positive predictive value of 92.1%, and a negative predictive value of 98.5% compared with chest radiography for confirming the placement of central venous catheters.

Conclusions: In the setting of central venous catheter placement, postprocedural contrast-enhanced US imaging is a safe, efficient, and highly specific confirmatory test for the catheter tip location compared with chest radiography.

Keywords: catheter; critical care; emergency medicine; position; radiography; ultrasound.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Catheterization, Central Venous / instrumentation*
  • Catheterization, Central Venous / methods
  • Central Venous Catheters*
  • Contrast Media*
  • Humans
  • Image Enhancement / methods*
  • Jugular Veins / diagnostic imaging
  • Sensitivity and Specificity
  • Subclavian Vein / diagnostic imaging
  • Ultrasonography, Interventional / methods*


  • Contrast Media