title: Retrospective analysis of contrast-enhanced computed tomographic findings related to obstructive shock due to ascending aortic dissection.
abstract: OBJECTIVE
  The objective of this study was to evaluate contrastenhanced computed tomography findings related to obstructive shock due to ascending aortic dissection (AAD).
  
  
  METHODS
  The computed tomography findings in 9 AAD patients with shock, 11 AAD patients without shock, and 18 control subjects were evaluated for (1) pericardial effusion, (2) diameter of the inferior vena cava, (3) periportal hypodensity, (4) retrograde reflux of contrast material, (5) aortic and visceral enhancement, and (6) other factors (peripancreatic edema, bowel thickening/dilatation).
  
  
  RESULTS
  Patients with shock showed the highest ratio of pericardial effusion, periportal hypodensity, and retrograde reflux of contrast material; largest inferior vena cava diameter; stronger aortic enhancement in both the arterial and portal phases; lowered splenic and pancreatic enhancement in the arterial phase; and stronger visceral (especially adrenal) enhancement, except for the renal medulla in the portal phase.
  
  
  CONCLUSIONS
  Computed tomography findings related to obstructive shock due to AAD reflected impaired diastolic filling, decreased cardiac output, and flow redistribution in visceral organs.
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan. k.sasaguri@gmail.com
authors.forename: Kohei
authors.initials: K
authors.lastname: Sasaguri
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Takeshi
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kamochi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Egashira
authors.forename: Junichi
authors.initials: J
authors.lastname: Nojiri
authors.forename: Sho
authors.initials: S
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging*; D002302:Cardiac Output; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011168:Portal System / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012769:Shock / Q000000981:diagnostic imaging* / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol