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Letter to the Editor

When Beauty Hides a Beast

Authors:

H Devos ,

Department of 1. Radiology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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L Goethals,

Department of Radiology, Nuclear Medicine, Universitair Ziekenhuis Brussel, Brussels, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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D E Verdries,

Department of 1. Radiology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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K De Smet,

Department of Radiology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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F De Geeter,

Department of Nuclear Medicine, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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J De Mey

Department of Radiology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium, BE
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Abstract

We present a 43-year old female patient, admitted to the intensive care unit, recovering from a Bentall procedure because of a supra-coronary aneurysm and unicuspid aortic valve. Few hours following surgery,a marked lactic acidosis, hypoxemia and increased central venous pressure developed. Pulmonary angio-CT was performed to exclude pulmonary embolism. Because of severe peripheral vasoconstriction, iodine contrast could only be administered through a narrow lumen central venous catheter, which limited the maximum flow rate to 1.5 ml/s. Images were performed with triggering in the pulmonary trunk. Review of the images showed no evidence for pulmonary embolism. Despite the low flow rate, a clear enhancement of the pulmonary artery was observed (up to 460 HU) (Fig. 1). Such an enhancement of the pulmonary artery is normally only achieved when injecting contrast at a flow rate of 4-5 ml/s. These perfect images, obtained at a low contrast flow rate in fact indicate severely impaired right ventricular function.

How to Cite: Devos, H. et al., (2014). When Beauty Hides a Beast. Journal of the Belgian Society of Radiology. 97(3), pp.192–195. DOI: http://doi.org/10.5334/jbr-btr.79
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Published on 01 May 2014.

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