Birnbaum B A, Nelson R C, Chezmar J L, Glick S N
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Radiology. 1999 Aug;212(2):431-8. doi: 10.1148/radiology.212.2.r99au14431.
To assess the ability of an extravasation detection accessory (EDA) to detect clinically important (> or = 10 mL) extravascular injection of iodinated contrast material delivered with an automated power injector.
Five hundred patients referred for contrast material-enhanced body computed tomography (CT) participated in a prospective, multi-institutional, observational study in which the EDA was used to identify and interrupt any injection associated with clinically important extravasation. The presence or absence of extravasation was definitively established with helical CT at the injection site (injection rate, from 1.0 to 5.0 mL/sec; mean, 2.9 mL/sec; median, 3.0 mL/sec).
There were four true-positive (extravasation volumes, 13-18 mL), 484 true-negative, 12 false-positive, and no false-negative cases. The prevalence of overall and clinically important (> or = 10 mL) extravasation was 3.6% (18 of 500 cases) and 0.8% (four of 500 cases), respectively. The EDA had a sensitivity of 100% (four of four cases; 95% CI: 51%, 100%) and a specificity of 98% (484 of 496 cases; 95% CI: 96%, 99%) in the detection of clinically important extravasation.
The EDA is easy to use, safe, and accurate in the monitoring of intravenous injections for extravasation, which could prove especially useful in high-flow-rate CT applications.
评估一种外渗检测附件（EDA）检测通过自动动力注射器注入的碘化对比剂发生具有临床意义（≥10 mL）血管外注射的能力。
500例因对比剂增强体部计算机断层扫描（CT）而就诊的患者参与了一项前瞻性、多机构观察性研究，其中使用EDA识别并中断任何与具有临床意义的外渗相关的注射。通过螺旋CT在注射部位（注射速率为1.0至5.0 mL/秒；平均为2.9 mL/秒；中位数为3.0 mL/秒）明确是否存在外渗。
有4例假阳性（外渗量为13 - 18 mL）、484例假阴性、12例假阳性，无假阴性病例。总体外渗和具有临床意义（≥10 mL）外渗的发生率分别为3.6%（500例中的18例）和0.8%（500例中的4例）。在检测具有临床意义的外渗方面，EDA的灵敏度为100%（4例中的4例；95%可信区间：51%，100%），特异度为98%（496例中的484例；95%可信区间：96%，99%）。
EDA在监测静脉注射外渗方面易于使用、安全且准确，这在高流速CT应用中可能特别有用。
