Dependent layering of venous refluxed contrast: A sign of critically low cardiac output

Ian W Sullivan; Partha Hota; Farouk Dako; Shqiponja Hajdinaj; Blachy Davila

doi:10.1016/j.radcr.2018.10.021

Dependent layering of venous refluxed contrast: A sign of critically low cardiac output

Radiol Case Rep. 2018 Nov 15;14(2):230-234. doi: 10.1016/j.radcr.2018.10.021. eCollection 2019 Feb.

Authors

Ian W Sullivan¹, Partha Hota¹, Farouk Dako¹, Shqiponja Hajdinaj¹, Blachy Davila¹

Affiliation

¹ Department of Radiology, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19140, USA.

Abstract

Mortality associated with cardiogenic shock can reach 80%. Although most often diagnosed clinically, the hemodynamics of cardiogenic shock may manifest on contrast-enhanced computed tomography as dependent layering of contrast within the inferior vena cava (IVC), a finding referred to as the "IVC level sign." Herein we present 2 cases of the IVC level sign. Swift recognition of the IVC level sign and awareness of its dire prognostic implications is essential for achieving the best patient outcomes.

Keywords: CT; Contrast level; IVC level sign.

Publication types

Case Reports