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Dependent Pooling

A Contrast-Enhanced Sign of Cardiac Arrest During CT

Po-Pang Tsai1, Jeon-Hor Chen1, Jung-Lin Huang2 and Wu-Chung Shen1

1 Department of Radiology, China Medical College Hospital, No. 2, Yuh-Der Rd., Taichung 404, Taiwan.
2 Department of Radiology, Taichung Veterans General Hospital, No. 160, Sect. 3, Taichung Harbor Rd., Taichung 404, Taiwan.



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  		Fig. 1A. —Contrast-enhanced CT scans in 84-year-old woman with type I aortic dissection. Scan at level of thoracic inlet shows stasis of contrast agent in right subclavian vein and right brachiocephalic vein. Note regurgitation of contrast agent into left jugular vein (long arrowhead), left subclavian vein (short arrowhead), and venules in upper back. Also note enhanced accessory hemiazygous vein in left prevertebral area.

 


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  		Fig. 1B. —Contrast-enhanced CT scans in 84-year-old woman with type I aortic dissection. Scan at level of hepatic hilum reveals densely opacified parenchyma in right lobe of liver due to retrograde flow from inferior vena cava. Note unusual opacification of right portal vein (arrow), main portal vein, and hepatic artery (arrowhead).

 


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  		Fig. 1C. —Contrast-enhanced CT scans in 84-year-old woman with type I aortic dissection. Scan at level of ascending aorta shows type A aortic dissection. Note sedimentation of contrast agent in azygous (large arrowhead) and hemiazygous (small arrowhead) veins. Pulmonary artery is densely opacified, but aorta is faintly enhanced.

 


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  		Fig. 1D. —Contrast-enhanced CT scans in 84-year-old woman with type I aortic dissection. Scan at level of renal hilum shows stasis of contrast agent in dependent portion of inferior vena cava and regurgitation into right renal vein (arrowhead). Note densely opacified vessels in right lobe of liver and faintly enhanced aorta.

 


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  		Fig. 1E. —Contrast-enhanced CT scans in 84-year-old woman with type I aortic dissection. Scan at lower level of abdomen shows contrast agent in dependent portion of both aorta and inferior vena cava. Note unusual opacification of right ovarian vein (arrowhead).

 


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  		Fig. 2. —20-year-old woman injured in car crash. Contrast-enhanced CT scan at level of kidney shows contrast material pooling in right renal parenchyma. Note small caliber abdominal aorta and blood—contrast level in inferior vena cava.

 


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  		Fig. 3A. —Contrast-enhanced CT scans in 77-year-old woman with dissecting aortic aneurysm. Scan at level of ascending aorta shows dense opacification of azygous vein (arrowhead) and abundant venous plexus in back area. Dissected aorta is not enhanced.

 


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  		Fig. 3B. —Contrast-enhanced CT scans in 77-year-old woman with dissecting aortic aneurysm. Scan at level of heart shows enhancement of right ventricle and superior vena cava. Left heart chambers are not opacified. Note enhanced great cardiac vein (arrowhead) and hemiazygous vein.

 


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  		Fig. 3C. —Contrast-enhanced CT scans in 77-year-old woman with dissecting aortic aneurysm. Scan 2 cm caudal to B shows opacification of right ventricle, right atrium, right hepatic veins, and vena cava. Note regurgitation of contrast agent into coronary sinus (arrowhead).

 


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  		Fig. 4. —75-year-old woman with right middle cerebral artery infarction and suspected intraabdominal abscess formation. Contrast-enhanced CT scan at level of heart shows no enhancement of cardiac chambers. Contrast agent deposits in dependent portion of superior vena cava. Note unusual enhancement of azygous and hemiazygous veins.

 


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  		Fig. 5. —49-year-old man with sepsis and suspected intraabdominal infection. Anteroposterior radiograph of chest obtained after CT shows stasis of contrast agent in dependent portions of right side of body, including right subclavian vein, vena cava, right hepatic veins, right renal vein, bilateral posterior intercostal veins, ascending lumbar vein, azygous vein, and abundant venous plexus in upper chest and neck areas.

 

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