| 贾晓茜,陈姣,黄欣,王怡名,史医蕾,郭建新.胸部CTA检查注射对比剂后静脉空气栓子成因及对策[J].中国医学影像技术,2019,35(9):1400~1403 |
| 胸部CTA检查注射对比剂后静脉空气栓子成因及对策 |
| Causes and countermeasures of venous air embolism after injection of contrast media during chest CTA |
| 投稿时间：2019-03-25 修订日期：2019-07-02 |
| DOI：10.13929/j.1003-3289.201903180 |
| 中文关键词: 注射,静脉内 对比剂 栓塞,空气 体层摄影术,X线计算机 血管造影术 |
| 英文关键词:injection, intravenous contrast media embolism, air tomography, X-ray computed angiography |
| 基金项目:陕西省国际科技合作与交流计划项目（2016KW-016）、西安交通大学第一附属医院3D打印医学研究课题（XJTU1AF-3D-2018-003）、西安交通大学第一附属医院院基金（2018HL-11）。 |
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| 中文摘要: |
| 目的 探讨胸部CTA注射对比剂后发生静脉空气栓塞（VAE）的原因和相应对策。方法 连续收集4 900例胸部CTA图像，观察VAE发生率、栓子个数、大小、部位及形态等。结果 VAE发生率为4.65%（228/4 900），228例共见318个栓子，其中呈气泡状285个，气-液平面形态33个；位于右心房155个，肺动脉主干108个，上腔静脉17个，右心室13个，左头臂静脉13个，右头臂静脉12个；直径（2.41±1.45）mm；小量VAE占90.35%（206/228），中量占9.65%（22/228），无大量VAE发生。不同性别、类别（住院/门诊）患者、检查设备、对比剂种类和注射剂量间VAE发生率差异均无统计学意义（P均>0.05）。冠状动脉CTA后VAE发生率（193/3 771，5.12%）高于胸主动脉CTA（25/849，2.94%，P=0.007）。结论 胸部CTA检查注射对比剂后VAE发生率较低，且多无症状，但仍应引起重视并采取相应措施避免其发生或降低发生率。 |
| 英文摘要: |
| Objective To explore the causes and countermeasures of venous air embolism (VAE) after injection of contrast medium during chest CTA. Methods Totally 4 900 patients who underwent chest CTA were collected consecutively. The incidence, number, size, location, shape and other information of VAE were observed. Results The incidence of VAE was 4.65% (228/4 900). A total of 318 air emboli were found in 228 patients, in which 285 manifested as air bubbles and 33 as air-liquid planes. There were 155 emboli located in the right atrium, 108 in the main pulmonary artery, 17 in the superior vena cava, 13 in the right ventricle, 13 in the left cephalombrachial vein and 12 in the right cephalombrachial vein, with the average diameter of (2.41±1.45) mm. Small amount of VAE was 90.35% (206/228), medium amount of VAE was 9.65% (22/228), and no large amount of VAE was found. There was no significant difference of the incidence of VAE among different genders, patient types (inpatients/outpatients), examination equipments, contrast agent types nor injection dose (all P>0.05). The incidence of VAE after coronary CTA (193/3 771, 5.12%) was higher than that after thoracic aorta CTA (25/849, 2.94%, P=0.007). Conclusion The incidence of VAE is low. Most VAEs are asymptomatic after injection of contrast medium during chest CTA examination, but radiologists should still pay attention to VAE and take appropriate measures to avoid or reduce the incidence of VAE. |
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