背景:计算机断层扫描(CT)期间碘化对比材料的外渗是一种罕见的并发症。少数患者可能会出现严重的并发症,例如骨筋膜室综合征。
目的:本研究的目的是回顾性评估患病率,严重程度,管理,以及我们机构中造影剂外渗的结果,并与现有文献中的报道进行比较。
方法:这是一项研究伦理委员会(REB)批准的回顾性研究,包括2019年至2022年在三级儿科中心接受静脉造影增强CT检查的11名患者。并经历碘化造影剂外渗作为并发症。年龄,体重,性别,合并症,血管导管尺寸,静脉通路位置,总对比度体积,流量,患者的症状,损伤的严重程度,和管理被收集。对于系统审查,遵循PRISMA指南。
结果:在儿童同期进行的3638次静脉造影CT中,仅发生了11次(0.3%)(0.17-0.54(95CI))造影剂外渗。中位年龄(IQR)为12.5(10.0,15.0)岁。在我们的队列中,1/11患者出现筋膜室综合征,需要筋膜切开术。系统评价评估了12篇文章,代表110名外渗儿童。按年龄分层的文章的合并患病率为0.32%(0.06-0.58%(95CI))。只有三个孩子经历了中度至重度并发症。
结论:我们确认造影剂外渗的严重并发症很少见,可发生在任何年龄。没有看到与需要手术咨询的强烈关联(包括年龄,性别,体重,流量,注射部位,导管尺寸,和对比度类型)。
Extravasation of iodinated contrast material during computed tomography (CT) is a rare complication. A few patients may develop severe complications such as compartment syndrome.
The purpose of this study was to retrospectively assess the prevalence, severity, management, and outcome of contrast extravasations in our institution and to perform a comparison to what has been reported in the existing literature.
This is a research ethics board (REB)-approved retrospective study comprising 11 patients who had intravenous contrast-enhanced CT between 2019 and 2022 in a tertiary pediatric center, and experienced extravasation of iodinated contrast as a complication. Age, weight, sex, co-morbidities, angiocatheter size, venous access location, total contrast volume, flow rate, patient\'s symptoms, severity of injury, and management were collected. For the systematic
review, PRISMA guidelines were followed.
Only 11 (0.3%) (0.17-0.54 (95%CI)) contrast extravasations occurred in a total of 3638 CTs performed with intravenous contrast during the same period in children. The median age (IQR) was 12.5 (10.0, 15.0) years. In our cohort, 1/11 patients developed compartment syndrome and required fasciotomy. The systematic
review assessed 12 articles representing a population of 110 children with extravasations. Pooled prevalence from articles stratified by age was 0.32% (0.06-0.58% (95%CI)). Only three children experienced moderate to severe complications.
We confirm that severe complications of contrast extravasation are rare and can occur at any age. No strong associations were seen with the need for surgical consultation (including age, sex, weight, flow rate, injection site, catheter size, and type of contrast).