J Korean Soc Emerg Med.  2005 Jun;16(3):334-338.

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

• Lee EJ
• Choi DS
• Park ED
• Kim SS

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.

Keyword

Cardiac arrest; Trauma; Computed tomography (CT)

MeSH Terms

Aorta, Abdominal
Coronary Sinus
Gonads
Heart Arrest*
Heart Atria
Hepatic Veins
Humans
Hypovolemia*
Portal Vein
Renal Veins
Retrospective Studies
Shock*
Strikes, Employee
Tomography, X-Ray Computed*
Veins
Vena Cava, Inferior