THORACIC CT FINDINGS AT HYPOVOLEMIC SHOCK

Purpose. To describe and discuss the thoracic CT features of hypovolem ic shock. Material and Methods: From a group of 18 patients with signs of hypovolemia on contrast-enhanced abdominal CT, 11 were selected fo r our study as having also undergone a complete chest examination. Pul se rate, blood pressure, trauma score value, Glasgow coma scale value, surgical result, and final outcome were retrospectively evaluated. Th e CT features analyzed were: decreased cardiac volume, reduced caliber of the thoracic aorta, aortic branches and caval venous system, incre ased enhancement of the aorta, and increased enhancement of the pulmon ary collapses/contusions. Results: All 11 subjects presented severe in juries and hemodynamic instability; 7 were stable enough to undergo su rgery; only 1 of the 11 survived. Two patients showed none of the feat ures of thoracic hypovolemia. All the other patients presented at leas t two signs: reduced caliber of the thoracic aorta in 7 cases; decreas ed volume of the cardiac chambers and increased aortic enhancement in 6; decreased caliber of the aortic vessels in 4; decreased caliber of the caval veins in 3; and increased enhancement of the pulmonary colla pses/contusions in 3. Conclusions: In patients with hypovolemia, CT ma y show several thoracic findings in addition to abdominal ones. Knowle dge of these features is important for distinguishing them from trauma tic injuries.