Herts B R, O'Malley C M, Wirth S L, Lieber M L, Pohlman B
Department of Radiology, Hb6, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA.
AJR Am J Roentgenol. 2001 Feb;176(2):447-53. doi: 10.2214/ajr.176.2.1760447.
This study evaluates the feasibility, safety, and efficacy of power-injecting IV contrast media through central venous catheters for CT examinations.
Two hundred ninety-five CT examinations were performed during an 18-month period in 225 patients with indwelling central venous catheters. Patients were randomized to power injection either through peripheral IV catheter or through central venous catheter. Feasibility was defined as the percentage of patients with contrast material injected successfully through the randomized access route. Safety was evaluated by comparing patients with complications. Efficacy was evaluated by comparing contrast enhancement of the thoracic aorta, pulmonary artery, abdominal aorta, and liver.
Two hundred nine patients had randomization data recorded. One hundred three (94%) of 109 patients were successfully injected through their indwelling catheter compared with 42 (42%) of 100 through a peripherally placed IV catheter (p < 0.001). After reassignment for unsuccessful access, 174 patients underwent central venous catheter injection, and 51, peripheral IV catheter injection. No statistically significant difference was noted in the complications between the central venous catheter and peripheral IV catheter groups. Enhancement was greater in the thoracic aorta, pulmonary artery, and liver for the peripheral IV catheter group (p < 0.03).
Power injection of contrast media through central venous catheters for CT examinations is feasible and safe when set hospital guidelines and injection protocols are followed. This technique provides an acceptable alternative in patients without adequate peripheral IV access when bolus contrast enhancement is desired.
本研究评估通过中心静脉导管进行CT检查时高压注射静脉造影剂的可行性、安全性和有效性。
在18个月期间，对225例留置中心静脉导管的患者进行了295次CT检查。患者被随机分为通过外周静脉导管或中心静脉导管进行高压注射。可行性定义为通过随机分配的通路成功注射造影剂的患者百分比。通过比较有并发症的患者来评估安全性。通过比较胸主动脉、肺动脉、腹主动脉和肝脏的对比增强来评估有效性。
209例患者记录了随机化数据。109例患者中有103例（94%）通过留置导管成功注射，而100例通过外周静脉导管注射的患者中有42例（42%）成功注射（p<0.001）。在重新分配未成功的通路后，174例患者接受中心静脉导管注射，51例接受外周静脉导管注射。中心静脉导管组和外周静脉导管组之间在并发症方面未观察到统计学上的显著差异。外周静脉导管组在胸主动脉、肺动脉和肝脏的增强更大（p<0.03）。
当遵循既定的医院指南和注射方案时，通过中心静脉导管进行CT检查时高压注射造影剂是可行且安全的。当需要团注对比增强且患者外周静脉通路不佳时，该技术提供了一种可接受的替代方法。
