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A rapid caliber change in the inferior vena cava during multiphasic contrast-enhanced computed tomography may signal
Takayoshi Shinya1, Akihiro Tada2, Yoshihisa Masaoka2
1Departments of Pediatric Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
Abstract:
Severe anaphylactic reactions to an intravenous nonionic iodine contrast medium (NICM) are uncommon but can result in permanent morbidity or death if not managed appropriately. An anaphylactic reaction to an NICM typically manifests as clinical symptoms that include an itchy nose, sneezing, and skin redness. To our knowledge, a rapid change in the caliber of the inferior vena cava (IVC) during multiphasic contrast-enhanced computed tomography (CT) has not been reported. Here, we report the computed tomographic findings in three cases of hypovolemic shock caused by an anaphylactic reaction to an NICM. We suspect that a decrease in caliber of the IVC during multiphasic contrast-enhanced CT may be a predictor of an allergic-like reaction to an NICM. Patients in whom physicians and radiographers detect a rapid caliber change in the IVC during multiphasic contrast-enhanced CT should be managed carefully.
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