Key result
Obstructive shock in ascending aortic dissection was associated with higher rates of pericardial effusion, periportal hypodensity, retrograde reflux, and altered visceral enhancement on CT.
Why the study?
What are the contrast-enhanced computed tomography findings related to obstructive shock in patients with ascending aortic dissection?
Observational (n=38)
What are the contrast-enhanced computed tomography findings related to obstructive shock in patients with ascending aortic dissection?
Contrast-enhanced computed tomography findings in ascending aortic dissection patients with obstructive shock reflect impaired diastolic filling, decreased cardiac output, and visceral flow redistribution.
CT features may aid recognition of obstructive shock in ascending aortic dissection; leaves open prospective validation for risk stratification.
OBJECTIVE: The objective of this study was to evaluate contrastenhanced computed tomography findings related to obstructive shock due to ascending aortic dissection (AAD). METHODS: The computed tomography findings in 9 AAD patients with shock, 11 AAD patients without shock, and 18 control subjects were evaluated for (1) pericardial effusion, (2) diameter of the inferior vena cava, (3) periportal hypodensity, (4) retrograde reflux of contrast material, (5) aortic and visceral enhancement, and (6) other factors (peripancreatic edema, bowel thickening/dilatation). RESULTS: Patients with shock showed the highest ratio of pericardial effusion, periportal hypodensity, and retrograde reflux of contrast material; largest inferior vena cava diameter; stronger aortic enhancement in both the arterial and portal phases; lowered splenic and pancreatic enhancement in the arterial phase; and stronger visceral (especially adrenal) enhancement, except for the renal medulla in the portal phase. CONCLUSIONS: Computed tomography findings related to obstructive shock due to AAD reflected impaired diastolic filling, decreased cardiac output, and flow redistribution in visceral organs.
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Sasaguri et al. (2012) conducted an observational in Ascending aortic dissection (n=38). Obstructive shock vs. Ascending aortic dissection without shock and control subjects was evaluated on Contrast-enhanced computed tomography findings including pericardial effusion, inferior vena cava diameter, and visceral enhancement. Obstructive shock in ascending aortic dissection was associated with higher rates of pericardial effusion, periportal hypodensity, retrograde reflux, and altered visceral enhancement on CT.
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