小剂量造影剂引起造影剂脑病1例报道及文献复习

Contrast-induced encephalopathy by low dose contrast agent:a case report and literature review

目的提高对冠状动脉造影后引起的罕见并发症——造影剂脑病的识别及诊治水平。方法分析1例48岁冠状动脉心肌桥患者冠状动脉造影后出现造影剂脑病的临床、影像表现及诊治过程,并回顾相关文献。结果患者主要临床表现为头晕、视物模糊、双眼复视、脚踩棉花感。眼眶CT及头颅CT检查均未见明显异常。经水化及对症支持治疗后康复,未留后遗症。结论造影剂脑病临床症状多样,影像学表现一般无明显异常,是一种罕见的严重并发症,但如发现及时、处置妥当可有效防止不可逆性损害的发生,改善患者的预后。

Objective To increase the recognition and levels of diagnosis and treatment of contrast-induced encephalopathy as a rare complication after coronary angiography.Methods The clinical symptoms,imaging manifestation,diagnosis and treatment process of a 48-year-old patient with contrast-induced encephalopathy after coronary angiography were analyzed,and the literature was reviewed.Results The main clinical manifestations were dizziness,blurred vision,double vision and feeling of stepping on cotton.Orbital CT and head CT showed no obvious abnormalities,and recovered after hydration and symptomatic support treatment without sequelae.Conclusion Contrast-induced encephalopathy is a rare and serious complication with various clinical symptoms and no obvious abnormalities in imaging manifestations.However,if finding in time and proper handling,the occurrence of irreversible damage can be effectively prevented and the prognosis of the patients will be improved.