{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T15:00:18Z","timestamp":1778166018916,"version":"3.51.4"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":101,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Radiol Imaging"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2003This article provides evidence that detection of venous air microbubbles (VAMB) in chest computed tomography angiography (CTA) can be an indicator for \u201cnormalization of deviance\u201d phenomenon in CT.<\/jats:p><jats:p>\n          Method and Materials\u2003Institutional review board-approved retrospective study, with waiver for informed consent. Contrast-enhanced chest CT performed during 6 months were reviewed for presence of VAMB in venous segments visible in chest CT (subclavian, brachiocephalic vein, superior vena cava) and cardiac chambers. VAMB volumes were quantified through a semiautomatic method (MIAlite plugin for OsiriX), using a region of interest (ROI) covering the bubble. With basal results, protocols for correct injection technique were reinforced, and VAMB were estimated again at 1 and 3 months. Six months later, questionnaires were sent to the CT technologists to inquire about their perception of VAMB. Descriptive measures with central distribution and dispersion were performed; statistical significance was considered at p\u2009&lt;\u20090.05.<\/jats:p><jats:p>\n          Results\u2003A total of 602 chest CTA were analyzed, 332 were women (55.14%), with a median age of 58 (interquartile range [IQR] 44\u201372) years. Among those, 16.11% (100 cases) presented VAMB. Most were emergency department patients (51.6%), male (50.3%), with a median age of 54 (IQR 26) years. There was no difference on detection of VAMB regarding sex (p\u2009=\u20090.19), age (p\u2009=\u20090.46), or referral diagnosis (p\u2009=\u20090.35). Mean air bubbles volume was 0.2\u2009mL (range 0.01\u20133.4\u2009mL). After intervention, the number of exams with VAMB dropped to 3.29 % (3\/91) (p\u2009&lt;\u20090.001). On the 6-month query, 50% of the technicians still considered that VMAB is inevitable, and 60% thought that the occurrence is not associated to risk, and therefore, not actionable.<\/jats:p><jats:p>\n          Conclusion\u2003VAMB are a frequent finding in chest CTA, and being independent from patient-related variables, it is likely due to technical issues such as intravenous access manipulation during the exam. Reduction after reinforcement of proper performance, and certification of a low concern from CT technicians for any risk associated, provides evidence that there is normalization of deviance in this everyday procedure.<\/jats:p>","DOI":"10.1055\/s-0041-1741093","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T23:58:42Z","timestamp":1641859122000},"page":"805-808","source":"Crossref","is-referenced-by-count":2,"title":["Venous Air Microembolism in Chest CT Angiography: Evidence of Normalization of Deviance Phenomenon"],"prefix":"10.1055","volume":"31","author":[{"given":"Claudio","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Radiology, Clinica Alemana de Santiago, School of Medicine, Clinica Alemana - Universidad del Desarrollo, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ema","family":"Leal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Clinica Alemana de Santiago, School of Medicine, Clinica Alemana - 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