Collins M A, Pidgeon J W, Fitzgerald R
Department of Radiology, New Cross Hospital, Wolverhampton, UK.
Br J Radiol. 1995 Oct;68(814):1058-60. doi: 10.1259/0007-1285-68-814-1058.
Six patients undergoing dynamic contrast enhanced abdominal computed tomography (CT) for upper abdominal symptoms and signs are described. Each patient demonstrated early, intense opacification of the inferior vena cava (IVC) and hepatic veins, exceeding that in the aorta on scans through the upper abdomen. Opacification of the IVC returned to normal on more caudal slices. All six patients were found to have echocardiographically proven tricuspid regurgitation (TR). It is suggested that this sign occurs in patients with TR due to direct reflux of contrast 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 symptoms and signs.
本文描述了6例因上腹部症状和体征接受动态对比增强腹部计算机断层扫描（CT）的患者。每位患者在下腔静脉（IVC）和肝静脉早期均表现出强烈的造影剂充盈，在上腹部扫描时超过主动脉内的造影剂充盈。在下腹部层面，IVC的造影剂充盈恢复正常。所有6例患者经超声心动图证实均有三尖瓣反流（TR）。提示该征象出现在TR患者中，是由于在长时间团注注射过程中造影剂从右心房直接反流至IVC。CT的其他表现包括4例患者肝脏实质呈斑片状强化，5例患者有腹水。认识到这一简单征象可引导临床医生考虑上腹部症状和体征的心脏病因。
