Thoracic and Abdominal CT Findings of Hypovolemic Shock Patients with Cardiac Arrest During CT Examination

Lee,  Eun Joo; Choi,  Dae Seob; Park,  Eui Dong; Kim,  Sam Soo

J Korean Soc Emerg Med > Volume 16(3); 2005 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2005;16(3): 334-338.

Thoracic and Abdominal CT Findings of Hypovolemic Shock Patients with Cardiac Arrest During CT Examination

Eun Joo Lee, Dae Seob Choi, Eui Dong Park, Sam Soo Kim

¹Department of Diagnostic Radiology, Dongguk University College of Medicine, Gyeongju, Korea.
²Department of Diagnostic Radiology, Gyeongsang National University College of Medicine and Gyeongsang Institute of Health Science, Jinju, Korea. choids@nongae.gsnu.ac.kr
³Department of Radiology, Kwangwon National University College of Medicine, Chuncheon, Korea.

ABSTRACT

PURPOSE:
The purpose of this study is to describe the abdominal and the thoracic CT findings of cardiac arrest that occurs during CT examination.
METHODS:
We retrospectively reviewed CT findings of seven patients who had cardiac arrest during CT examination. A contrast-enhanced abdominal CT was performed in all patients, and a thoracic CT was performed in three of them.
RESULTS:
The injected contrast agent was mostly distributed in the venous system, forming a blood-contrast level in the superior or inferior vena cava in all patients. One of the most striking findings was regurgitation of the contrast medium via the inferior vena cava into the right hepatic and renal veins. The right hepatic vein and the dependent portion of the right hepatic parenchyma were strongly enhanced in all patients, and the portal vein was enhanced in four. Retrograde opacification of the right renal vein was seen in six patients, the right renal parenchyma and the right gonadal vein were opacified in four of those six patients. The abdominal aorta showed a small caliber in all patients, and it was faintly enhanced in one patient. Except for one patient, the left cardiac chambers were not opacified. Retrograde pooling of contrast agent via the right atrium into the coronary sinus was seen in five patient, and the great cardiac vein was also opacified in three of those five patients.
CONCLUSION:
The CT features of cardiac arrest are characterized by the forming of a blood-contrast level in the vena cava and retrograde strong contrast enhancement of the abdominal veins and the dependent portion of the right hepatic and renal parenchyma.

Key words: Cardiac arrest, Trauma, Computed tomography (CT)