COMPUTED-TOMOGRAPHY MANIFESTATIONS OF TRICUSPID REGURGITATION

Six patients undergoing dynamic contrast enhanced abdominal computed t omography (CT) for upper abdominal symptoms and signs are described. E ach patient demonstrated early, intense opacification of the inferior vena cava (IVC) and hepatic veins, exceeding that in the aorta on scan s through the upper abdomen. Opacification of the IVC returned to norm al on more caudal slices. All six patients were found to have echocard iographically proven tricuspid regurgitation (TR). It is suggested tha t this sign occurs in patients with TR due to direct reflux of contras t from the right atrium into the IVC during protracted bolus injection . Additional CT findings included patchy parenchymal liver enhancement in four patients and ascites in five. Recognition of this simple sign may direct the clinician to a cardiac aetiology for upper abdominal s ymptoms and signs.