CCTA检查中静脉积气分析

Analyzing Venous Air Emboli in the Coronary Artery Computerized Tomographic Angiography

目的探讨冠状动脉CT血管造影(CCTA)检查中静脉积气出现原因、可能风险分析及预防。方法回顾性分析1587例CCTA资料,统计静脉积气发生的频率、气体出现部位、形态及气体量,并统计注射对比剂前后其发生的频率。对相关资料采用Chi-Square tests分析。结果静脉积气发生频率10.7%(170/1586),其中发生于右心房76.5%(130/170)、右心室14.1%(24/170)、主肺动脉36.5%(62/170)、上腔静脉0.6%(1/170),单处78.8%(134/170),多处21.2%(36/170)。静脉气体注射对比剂前发现59.4%(101/170),注射对比剂后发现27.1%(46/170),注射对比剂前后均发现13.5%(23/170)。共发现387个气体,圆形或类圆形占84.4%(311/387),不规则形占13.7%(53/387),椭圆形占5.9%(23/387)。静脉气体量(16.32±25.14)×10-3ml,范围(0.07～110)×10-3ml。门诊发生频率11.4%(104/915),住院发生频率9.8%(66/671),两者发生频率差异无显著统计学意义(P=0.330>0.05)。男性发生率11.5%(122/1062),女性发生率9.2%(48/524),两者发生频率的差异无显著统计学意义(P=0.159>0.05)。64 MSCT检出率9.1%(92/1012),640 MSCT检出率13.6%(78/574),两者设备静脉积气检出率差异有显著统计学意义(P=0.005<0.05),640 CT检出率更高。结论在CCTA检查中,静脉积气患者绝大多数无明显临床症状,可能有潜在医疗风险,需引起重视。

Objective To investigate the cause, risk and preclusion of venous air emboli in the coronary artery computerized tomographic angiography（CCTA）. Methods CCTA findings of 1587 patients were reviewed. The frequency,location, type and volume of air emboli were statistically analyzed by Chi-Square tests. Results The frequency of air emboli was 10.7% （170/1586）. Among the 170 cases, air emboli located in the right atrium in 130 （76%）, right ventricle in 240 （14.1%） ,main pulmonary artery in 62（36.5% ） ,and superior vena cava in 1 case（O. 6% ）. Single air embolus was found in 134 cases （78.8%） ,multiple emboli in 36 cases （21.2%）. Air emboli were found before injection of contrast material in 101 cases（59.4% ）, after injection in 46cases （27.1%） and both in cases （ 13.5% ）. There were 387 air emboli. They were round or similarly round shape in 311 （84.4%）, anomalistic shape in 53 （ 13.7% ） and elliptoid shape in 23 （5.9%）. The average volume of air emboli was （ 16.32± 25.14）×10-3 ml, range from 0.07 ×10-3 ml to 110 ×10-3 ml. Conclusion Most of patients who found venous air emboli in the CCTA have no clinical complications . However,There may be potential medical risk, need to paid attention.