CTICasesEthiodol-Induced Fat Embolism Syndrome
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Imaging findings
A patient undergoing ethiodol embolization for a liver tumor developed immediate shortness of breath. CT demonstrated dense ethiodol contrast in the inferior vena cava. Lung windows showed patchy areas of crazy paving and a few septal lines. This was attributed to intrahepatic shunting leading to intravascular embolization of the lipid-based ethiodol contrast into the lungs. The patient improved with supportive oxygen therapy.
Key takeaways
This is a 'cool' iatrogenic case of fat embolism syndrome induced by ethiodol, a lipid-based contrast agent used in transarterial chemoembolization (TACE). Due to intrahepatic shunting, the ethiodol entered the systemic circulation and embolized to the pulmonary vasculature, causing the characteristic imaging findings of crazy paving and septal lines. It highlights a rare but distinct complication of this procedure.
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