■本研究的目的是评估在胸部计算机断层扫描血管造影(T-CTA)期间,静脉通路(IVA)部位的选择是否会影响主动脉衰减以及静脉装置放置的任何相关风险。
■对2013年1月1日至2015年8月14日之间进行的所有T-CTA检查进行回顾性审查,以确定通过替代(即非肘部)IVA(n=1769)进行造影剂注射的检查。使用时间匹配,选择肘前IVA检查(n=1769)作为对照。每次考试,在升主动脉中测量衰减。随后从纳入本研究的所有3538名患者收集患者和技术数据。使用多元线性回归来确定IVA部位是否影响衰减。最后,我们收集并比较了整个T-CTA队列的外渗相关数据.
■手/手腕,手臂,在衰减方面,中心静脉接入装置IVA均等同于肘前IVA(分别为P=0.579,P=0.599和P=0.522)。前臂和骨内IVA的衰减明显高于肘前IVA(分别为P=0.010和P=0.002)。与左侧IVA相比,右侧IVA与11Hounsfield单位的小衰减增加相关(P<0.001)。在外渗方面,肘前IVA相当于手/手腕,前臂,上臂IVA(P=0.778,P=0.060,P=0.090)。
■对于T-CTA成像,使用非肘前IVA实现的令人满意的主动脉衰减等同于使用肘前IVA实现的衰减。外周IVA装置造影剂外渗的风险相对较低,然而,适当的IVA部位选择应被视为未来成像研究成功使用造影剂的重要因素.当在经历造影剂的压力注射的高弯曲/移动范围的区域中使用外围IV装置时,这防止通过可预防的装置故障对患者造成不适当的伤害。
UNASSIGNED: The objective of this study was to evaluate whether the choice of intravenous access (IVA) site affects aortic
attenuation during thoracic computed tomographic angiography (T-CTA) and any associated risks with intravenous device placement.
UNASSIGNED: All T-CTA exams performed between 1/1/2013 and 8/14/2015 were retrospectively reviewed to identify those performed with contrast media injection via alternative (i.e. non-antecubital) IVA (n = 1769). Using time matching, antecubital IVA exams (n = 1769) were selected as controls. For each exam,
attenuation was measured in the ascending aorta. Patient and technical data was subsequently collected from all 3538 patients included in this study. Multiple linear regression was used to determine if IVA site affected
attenuation. Lastly, data related to extravasations for the entire T-CTA cohort were collected and compared.
UNASSIGNED: Hand/wrist, arm, and central venous access device IVA were all equivalent to antecubital IVA in terms of attenuation (P = 0.579, P = 0.599, and P = 0.522 respectively). Forearm and intraosseous IVA had significantly higher attenuation (P = 0.010 and P = 0.002, respectively) than antecubital IVA. Right-sided IVA was associated with a small attenuation increase of 11 Hounsfield Units (P < 0.001) compared to left-sided IVA. In terms of extravasation, antecubital IVA was equivalent to hand/wrist, forearm, and upper arm IVA (P = 0.778, P = 0.060, and P = 0.090 respectively).
UNASSIGNED: Satisfactory aortic
attenuation achieved with non-antecubital IVA is equivalent to
attenuation achieved with antecubital IVA for T-CTA imaging. The risk of contrast media extravasation in peripheral IVA devices was relatively low, however, appropriate IVA site selection should be considered an important factor for successful administration of contrast media for future imaging studies. This prevents undue harm to patients through preventable device failures when using a peripheral IV device in areas of high flexion/range of movements undergoing pressure injection for contrast media.