Poster électronique

Intérêt du 3D-CT en salle de radiologie interventionnelle pour l'implantation des cathéters veineux centraux
S. Henry, T. Martinelli, G. Goyault, M. Midulla, C. Lions, JP. Beregi - Lille - France
Congrès 2010
Résumé
Objectifs
Evaluer l'acquisition 3D-CT en salle d'angiographie lors de l'implantation de cathéters centraux afin d'éviter les complications liées au mauvais positionnement (thrombose, sténose, ESV, embole, érosion pariétale).
Matériels et méthodes
En prospectif, le positionnement distal des cathéters centraux jugulaires était étudié par acquisition Xper-CT (Philips, FD20). L'extrémité distale était positionnée sous la bronche souche droite (BSD) et au dessus de l'arc inférieur droit en scopie de face. L'acquisition XperCT était réalisée au décours immédiat du geste. Une double lecture était réalisée, indépendamment de la pose, pour vérifier la qualité image de la séquence et le niveau d'implantation.
Résultats
Quatorze patients (8 cathéters, 6 chambres) étaient inclus au 10/03/2010. L'acquisition Xper-CT était possible dans tous les cas. Une erreur de centrage ne permettait pas d'analyser l'extrémité du cathéter. La qualité image scanographique sans injection permettait difficilement d'identifier le départ de l'aorte et le toit de l'oreillette droite (OD) sur les coupes axiales. Par rapport à la BSD, le cathéter était positionné correctement (8/13), dans la veine cave supérieure (3/13) et dans l'OD (2/13). Un cathéter était retrouvé dans l'OD en Xper-CT alors que bien positionné sur les critères scopiques.
Conclusion
Une acquisition XperCT présente un intérêt limitéà des cas particuliers (anatomie modifiée, hypermobilité de l'extrémité distale…).
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2017-12-11 04.16 :
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