Diagnostic Value of Chest Computed Tomography in Cerebral Arterial Gas Embolism in Compressed‐Air Divers
Fei Yao, Lu Zhang, Xin Xiao, Wensai Ji, Qing Sun, Qiang SunObjective
Cerebral arterial gas embolism (CAGE) is a life‐threatening acute critical illness in compressed‐air diving, primarily induced by pulmonary barotrauma (PBT). This study aimed to analyze the chest computed tomography (CT) imaging features of CAGE patients, clarify the detection rules of PBT‐related lesions, and evaluate the clinical value of chest CT in the diagnosis and treatment guidance of CAGE.
Methods
A retrospective analysis was conducted on the medical records of 8 male compressed‐air divers diagnosed with CAGE who were admitted to the hyperbaric oxygen therapy (HBOT) center of No. 971 Hospital of the Chinese People’s Liberation Army Navy from August 2018 to September 2024. All patients underwent chest CT scans within 72 h of admission. Relevant data, including demographic information, diving details, clinical symptoms, chest CT findings, treatment regimens, and prognosis, were collected and analyzed using descriptive statistical methods.
Results
The main etiologies of the 8 patients were gas supply interruption (6 cases, 75%) and breath‐holding during decompression (2 cases, 25%). All patients presented with neurological symptoms, including unconsciousness (5 cases, 62.5%), hemiplegia (3 cases, 37.5%), and dizziness (3 cases, 37.5%), while 7 cases (87.5%) had concurrent respiratory symptoms. Chest CT detected pulmonary injuries in 7 cases (87.5%), including pneumothorax (6 cases, 75.0%), mediastinal emphysema (4 cases, 50.0%), subcutaneous emphysema (2 cases, 25.0%), and pulmonary bulla (1 case, 12.5%). All patients received comprehensive treatments, such as basic supportive care, recompression therapy, and/or HBOT. Follow‐up at 6 months showed that all patients achieved favorable outcomes, with most fully recovered and no severe disabilities.
Conclusion
CAGE in compressed‐air divers is highly associated with PBT. Chest CT exhibits high sensitivity in detecting pulmonary lesions, such as pneumothorax and mediastinal emphysema, providing potentially valuable evidence for early diagnosis, individualized treatment planning, and prognosis evaluation. Chest CT examination may be considered as part of the emergency evaluation for CAGE patients, particularly in cases with respiratory symptoms or when pneumothorax is clinically suspected, though further prospective studies are warranted to validate its routine use.