Samji Karim Bahadurali, Chandrarathna G Sanjaya, Khan Wasim, Jones Hefin, Owen Richard, Vethanayagam Dilini
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Edmonton HHT Center, Edmonton, AB T6G 2B7, Canada.
J Clin Med. 2025 Jul 8;14(14):4842. doi: 10.3390/jcm14144842.
Air embolism on contrast-enhanced computed tomography (CECT) scans may have significant consequences, particularly if a right-to-left shunt is present, as seen in hereditary hemorrhagic telangiectasia. We sought to evaluate the frequency of CECT-associated air emboli in a single tertiary care referral center. Consecutive non-enhanced and contrast-enhanced cardiac CT studies (NECCT and CECCT, respectively) were evaluated prospectively over a 6-month period. Following the University of Alberta's Health Research Ethics Board approval (code: Pro00042313; date: 1 May 2014), two experts reviewed all studies independently to assess for the presence and location of air emboli. The control group consisted of only NECCTs. All patients, except for the control group in this study, had an IV cannula placed. When present, the number, volume, and location of air emboli were recorded. In this study, 110 subjects underwent intravenous cannula placement and both NECCT and CECCT. Of these, 27 of the NECCT studies (24.5%) and 36 of the CECCT studies (32.7%) demonstrated intravascular air emboli. Of those with air emboli, the average volume of intravascular gas was 19.22 ± 25.35 µL in the NECCT studies, with most of the intravascular air (70.4%) seen in the right atrial appendage (RAA). The average volume of intravascular air was 14.81 ± 26.54 µL in the CECCT studies, with most of the intravascular air also located within the RAA (72.2%). The incidence of intravascular air was higher in the CECCT group (28.6% increase), with lower volumes of intravascular air. None of the subjects in the control group (n = 28), who underwent NECCT without intravenous cannulation, demonstrated air emboli. Air emboli were present in a significant proportion of subjects undergoing intravenous cannulation and subsequent CECT. The use of CECT should be carefully considered in high-risk populations.
在对比增强计算机断层扫描（CECT）中出现空气栓塞可能会产生严重后果，尤其是在存在右向左分流的情况下，如遗传性出血性毛细血管扩张症所见。我们试图评估在一家三级医疗转诊中心CECT相关空气栓塞的发生率。在6个月的时间里，对连续的非增强和对比增强心脏CT研究（分别为NECCT和CECT）进行了前瞻性评估。在获得阿尔伯塔大学健康研究伦理委员会批准（代码：Pro00042313；日期：2014年5月1日）后，两位专家独立审查了所有研究，以评估空气栓塞的存在和位置。对照组仅包括NECCT。除本研究中的对照组外，所有患者均放置了静脉套管。如有空气栓塞，记录其数量、体积和位置。在本研究中，110名受试者接受了静脉套管放置以及NECCT和CECT检查。其中，27项NECCT研究（24.5%）和36项CECT研究（32.7%）显示有血管内空气栓塞。在有空气栓塞的患者中，NECCT研究中血管内气体的平均体积为19.22±25.35微升，大部分血管内空气（70.4%）见于右心耳（RAA）。CECT研究中血管内空气的平均体积为14.81±26.54微升，大部分血管内空气也位于RAA内（72.2%）。CECT组血管内空气的发生率更高（增加28.6%），血管内空气体积更小。对照组（n = 28）中未进行静脉插管仅接受NECCT检查的受试者均未显示空气栓塞。在接受静脉插管并随后进行CECT的受试者中，相当一部分存在空气栓塞。在高危人群中应谨慎考虑使用CECT。
