1 All authors: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 North Caroline St, Rm 3140D, Baltimore, MD 21287.
AJR Am J Roentgenol. 2014 Jun;202(6):1166-70. doi: 10.2214/AJR.13.11730.
The purpose of this study was to compare the performance of a 20-gauge fenestrated catheter with an 18-gauge nonfenestrated catheter for i.v. contrast infusion during MDCT.
Two hundred five adult outpatients imaged on a dual-source 128-MDCT scanner with arterial phase body CT (flow rates, 5.0-7.5 mL/s) were randomized to either an 18-gauge nonfenestrated or 20-gauge fenestrated catheter. After randomization, any 18-gauge nonfenestrated subjects whose veins were deemed insufficient for that catheter gauge were assigned to a third cohort for placement of a 20-gauge fenestrated catheter. Catheter placement success, infusion rate, contrast volume, maximum pressure, complications, and aortic enhancement levels were recorded.
Catheters were placed on the first attempt in 97% (100/103) for 18-gauge nonfenestrated and 94% (96/102) for 20-gauge fenestrated placements and in two or fewer attempts in 99% of both groups. Mean infusion rates (5.74 mL/s for 18-gauge nonfenestrated and 5.58 mL/s for 20-gauge fenestrated placements) and aortic enhancement levels were not significantly different. Maximum pressure was higher with 20-gauge fenestrated catheters (mean ± SD, 230.5 ± 27.6 pounds per square inch [psi]) than 18-gauge nonfenestrated catheters (mean ± SD 215.6 ± 32.8 psi) (p = 0.002). One subject with an 18-gauge nonfenestrated catheter had a high-pressure alarm. In the third cohort, a 20-gauge fenestrated catheter was successfully placed in two or fewer attempts in 85% (28/33), with one minor extravasation attributed to vein insufficiency.
A 20-gauge fenestrated catheter performs similarly to an 18-gauge nonfenestrated catheter with respect to i.v. contrast infusion rates and aortic enhancement levels and can be placed in most subjects whose veins are deemed insufficient for an 18-gauge catheter.
本研究旨在比较在 MDCT 中静脉注射造影剂时，20 号有孔导管与 18 号无孔导管的性能。
205 例接受双源 128 层 MDCT 扫描仪进行动脉期体部 CT 检查的成年门诊患者（流速为 5.0-7.5ml/s），随机分为 18 号无孔导管组或 20 号有孔导管组。随机分组后，任何认为静脉条件不适合 18 号导管的 18 号无孔导管组患者，均被分配至第三组行 20 号有孔导管置管。记录导管置管成功率、输注率、造影剂容量、最大压力、并发症和主动脉强化水平。
103 例 18 号无孔导管组和 102 例 20 号有孔导管组首次置管成功率分别为 97%（100/103）和 94%（96/102），两组均有 99%的患者在两次尝试内成功置管。两种导管的平均输注率（18 号无孔导管组为 5.74ml/s，20 号有孔导管组为 5.58ml/s）和主动脉强化水平无显著差异。20 号有孔导管的最大压力（平均±标准差，230.5±27.6 磅/平方英寸[psi]）高于 18 号无孔导管（平均±标准差，215.6±32.8 psi）（p=0.002）。1 例 18 号无孔导管组患者出现高压报警。在第三组中，28 例 33 例患者中有 85%（28/33）在两次尝试内成功置管 20 号有孔导管，1 例因静脉条件不足导致轻微外渗。
20 号有孔导管在静脉造影剂输注率和主动脉强化水平方面与 18 号无孔导管相似，对于静脉条件不适合 18 号导管的大多数患者均可成功置管。
