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Thoracic CT findings at hypovolemic shock

A Rotondo1, O Catalano, R Grassi

  • 1Department of Radiology, University of Bari, Italy.

Acta Radiologica (Stockholm, Sweden : 1987)
|August 1, 1998
PubMed
Summary

Hypovolemic shock can present with specific thoracic computed tomography (CT) findings, including reduced vessel caliber and increased aortic enhancement. Recognizing these signs is crucial for differentiating shock from other injuries.

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Area of Science:

  • Radiology
  • Emergency Medicine
  • Cardiovascular Imaging

Background:

  • Hypovolemic shock is a life-threatening condition often associated with trauma.
  • Abdominal CT is commonly used to assess hypovolemia, but thoracic findings are less characterized.
  • Early identification of hypovolemic shock is critical for patient management.

Purpose of the Study:

  • To detail the thoracic computed tomography (CT) features associated with hypovolemic shock.
  • To enhance the diagnostic capabilities of CT in evaluating patients with suspected hypovolemia.
  • To differentiate hypovolemic shock findings from other thoracic pathologies.

Main Methods:

  • Retrospective analysis of 11 patients with hypovolemia identified on contrast-enhanced abdominal CT.

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  • Inclusion of patients who also underwent complete chest CT examinations.
  • Evaluation of clinical data including hemodynamic parameters and trauma scores.
  • Analysis of specific thoracic CT findings: cardiac volume, aortic and caval venous caliber, aortic enhancement, and pulmonary changes.

    • Main Results:

    • All 11 patients had severe injuries and hemodynamic instability; only 1 survived.
    • Common thoracic CT findings included reduced caliber of the thoracic aorta (7/11) and increased aortic enhancement (6/11).
    • Other observed features were decreased cardiac chamber volume (6/11), reduced caliber of aortic branches (4/11), and reduced caliber of caval veins (3/11).
    • Pulmonary collapses or contusions with increased enhancement were noted in 3 patients.

    Conclusions:

    • Thoracic CT can reveal characteristic signs of hypovolemic shock beyond abdominal findings.
    • These thoracic CT features are valuable for distinguishing hypovolemic shock from traumatic injuries.
    • Awareness of these imaging findings can improve diagnostic accuracy in critical care settings.