Rationale and Objectives
This study aimed to assess the effectiveness of practical preventive strategies (i.e.,
venous vulnerability assessment and prevention scan protocol rules) taken by our radiology
team (radiology nurses, radiology technicians, radiologists) on reducing extravasation
of contrast media (ECM) during CT.
Materials and Methods
A total of 73,931 patients who underwent contrast-enhanced CT scans between January
2013 and December 2019 were retrospectively included. Venous vulnerability assessment
by the radiology team began in 2015, and prevention scan protocol rules for the prevention
of ECM were added in 2017. We defined each period as follows: 2013–2014, no prevention
(Period A); 2015–2016, early prevention (Period B, venous vulnerability assessment
only); and 2017–2019: late prevention (Period C, venous vulnerability assessment with
prevention scan protocol rules). The incident reports, radiology reports, and medical
records of patients in whom ECM occurred were reviewed. We compared the frequency
of ECM during each period.
Results
ECM occurred in 0.39% (292/73,931) of the patients. The frequencies of ECM for Periods
A, B, and C were 0.62% (121/19,505), 0.43% (89/20,847), and 0.24% (82/33,579), respectively.
There were significant differences in the frequencies of ECM among the three periods
(Chi-squared test, p < 0.01).
Conclusion
Implementation of venous vulnerability assessment and prevention scan protocol rules
by a radiology team can be a practical and simple solution to reduce the risk of ECM
during CT.
Key Words
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References
- Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection.Radiology. 1998; 206: 637-640
- Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT.AJR Am J Roentgenol. 2010; 195: 825-829
- Contrast media reactions and extravasation: relationship to intravenous injection rates.Radiology. 1998; 209: 411-416
- MRI and CT contrast media extravasation: A systematic review.Medicine (Baltimore). 2018; 97: e0055
- Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections.Radiology. 2007; 243: 80-87
- Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans.Eur Radiol. 2018; 28: 5368-5375
- Extravasation of radiographic contrast material: recognition, prevention, and treatment.Radiology. 1996; 200: 593-604
- Intravenous contrast extravasation during CT: a national data registry and practice quality improvement initiative.JAm College Radiol: JACR. 2015; 12: 183-191
- Management of large volume CT contrast medium extravasation injury: technical refinement and literature review.J plastic, reconstruc aesthetic surg: JPRAS. 2008; 61 (discussion 5): 562-565
- Contrast medium extravasation injury: guidelines for prevention and management.Eur Radiol. 2002; 12: 2807-2812
- Contrast media extravasations in patients undergoing computerized tomography scanning: a systematic review and meta-analysis of risk factors and interventions.JBI database systemat rev implementat rep. 2018; 16: 87-116
- Implications of iodinated contrast media extravasation in the emergency department.Am J Emerg Med. 2018; 36: 294-296
- Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: a report on 502,391 injections.Clin Radiol. 2014; 69: 1264-1272
- Extravasation detection accessory: clinical evaluation in 500 patients.Radiology. 1999; 212: 431-438
- Vascular extravasation of contrast medium in radiological examinations: University of California San Diego Health System Experience.J Patient Saf. 2014; 10: 105-110
- Contrast Extravasation using Power Injectors for Contrast-Enhanced Computed Tomography in Children: Frequency and Injury Severity.Acad Radiol. 2019; 26: 1668-1674
- Contrast media extravasation: manual versus power injector.Med Princ Pract. 2005; 14: 107-110
- Study of patients with intravenous contrast extravasation on CT studies, with radiology staff and ward staff cannulations.J Med Imaging Radiat Oncol. 2012; 56: 163-167
- Extravasation of nonionic radiologic contrast media: efficacy of conservative treatment.Radiology. 1990; 176: 65-67
- Safe use of an intravenous power injector for CT: experience and protocol.Radiology. 1990; 176: 69-70
- Extravasation of iopamidol and iohexol during contrast-enhanced CT: report of 28 cases.Radiology. 1991; 180: 707-710
- Rôle of contrast media viscosity in altering vessel wall shear stress and relation to the risk of contrast extravasations.Med Eng Phys. 2016; 38: 1426-1433
- Rate of contrast material extravasations and allergic-like reactions: effect of extrinsic warming of low-osmolality iodinated CT contrast material to 37 degrees C.Radiology. 2012; 262: 475-484
- Preventing intravenous contrast extravasation in CT: A simple solution.J Am College Radiol: JACR. 2017; 14: 1326-1332
- CT of the abdomen with reduced tube voltage in adults: a practical approach.Radiographics. 2015; 35: 1922-1939
- State of the art: iterative CT reconstruction techniques.Radiology. 2015; 276: 339-357
- Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol.Eur Radiol. 2018; 28: 1719-1730
Article info
Publication history
Published online: March 01, 2022
Accepted:
January 9,
2022
Received in revised form:
January 5,
2022
Received:
October 31,
2021
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
