Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT

Benjamin M. Yeh, Philip Kurzman, Elyse Foster, Aliya Qayyum, Bonnie Joe, Fergus Coakley

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this investigation was to explore the clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. MATERIALS AND METHODS. We retrospectively identified 127 patients who underwent contemporaneous contrast-enhanced CT of the chest or abdomen and echocardiography. On CT, the presence of retrograde inferior vena cava or hepatic vein opacification and the rate of IV contrast injection (> 3 mL/sec, high; ≤ 3 mL/sec, low) were recorded. On echocardiography, the presence of tricuspid regurgitation, pulmonary hypertension, or right ventricular systolic dysfunction was recorded. RESULTS. Retrograde inferior vena cava or hepatic vein opacification was more common in studies performed with a high rather than a low contrast injection rate (28/56 vs 6/71 patients, respectively; p <0.01). This finding was 31% sensitive (5/16) and 98% specific (54/55) for right-sided heart disease at low contrast injection rates, and 81% sensitive (17/21) and 69% specific (24/35) at high injection rates. Multivariate logistic regression models showed that high injection rate, tricuspid regurgitation, pulmonary hypertension, and right ventricular systolic dysfunction were independent predictors of retrograde inferior vena cava or hepatic vein opacification (p <0.05 for each). CONCLUSION. Retrograde opacification of the inferior vena cava or hepatic veins on CT is a specific but insensitive sign of right-sided heart disease at low contrast injection rates, but the usefulness of this classic sign decreases with high injection rates. This realization is important because many centers increasingly use high-injection-rate CT.

Original languageEnglish (US)
Pages (from-to)1227-1232
Number of pages6
JournalAmerican Journal of Roentgenology
Volume183
Issue number5
StatePublished - Nov 2004
Externally publishedYes

Fingerprint

Hepatic Veins
Inferior Vena Cava
Injections
Right Ventricular Dysfunction
Tricuspid Valve Insufficiency
Pulmonary Hypertension
Echocardiography
Heart Diseases
Logistic Models
Abdomen
Thorax

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. / Yeh, Benjamin M.; Kurzman, Philip; Foster, Elyse; Qayyum, Aliya; Joe, Bonnie; Coakley, Fergus.

In: American Journal of Roentgenology, Vol. 183, No. 5, 11.2004, p. 1227-1232.

Research output: Contribution to journalArticle

Yeh, Benjamin M. ; Kurzman, Philip ; Foster, Elyse ; Qayyum, Aliya ; Joe, Bonnie ; Coakley, Fergus. / Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. In: American Journal of Roentgenology. 2004 ; Vol. 183, No. 5. pp. 1227-1232.
@article{763361f7d389459a98fdf47702142ef3,
title = "Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT",
abstract = "OBJECTIVE. The purpose of this investigation was to explore the clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. MATERIALS AND METHODS. We retrospectively identified 127 patients who underwent contemporaneous contrast-enhanced CT of the chest or abdomen and echocardiography. On CT, the presence of retrograde inferior vena cava or hepatic vein opacification and the rate of IV contrast injection (> 3 mL/sec, high; ≤ 3 mL/sec, low) were recorded. On echocardiography, the presence of tricuspid regurgitation, pulmonary hypertension, or right ventricular systolic dysfunction was recorded. RESULTS. Retrograde inferior vena cava or hepatic vein opacification was more common in studies performed with a high rather than a low contrast injection rate (28/56 vs 6/71 patients, respectively; p <0.01). This finding was 31{\%} sensitive (5/16) and 98{\%} specific (54/55) for right-sided heart disease at low contrast injection rates, and 81{\%} sensitive (17/21) and 69{\%} specific (24/35) at high injection rates. Multivariate logistic regression models showed that high injection rate, tricuspid regurgitation, pulmonary hypertension, and right ventricular systolic dysfunction were independent predictors of retrograde inferior vena cava or hepatic vein opacification (p <0.05 for each). CONCLUSION. Retrograde opacification of the inferior vena cava or hepatic veins on CT is a specific but insensitive sign of right-sided heart disease at low contrast injection rates, but the usefulness of this classic sign decreases with high injection rates. This realization is important because many centers increasingly use high-injection-rate CT.",
author = "Yeh, {Benjamin M.} and Philip Kurzman and Elyse Foster and Aliya Qayyum and Bonnie Joe and Fergus Coakley",
year = "2004",
month = "11",
language = "English (US)",
volume = "183",
pages = "1227--1232",
journal = "AJR. American journal of roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "5",

}

TY - JOUR

T1 - Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT

AU - Yeh, Benjamin M.

AU - Kurzman, Philip

AU - Foster, Elyse

AU - Qayyum, Aliya

AU - Joe, Bonnie

AU - Coakley, Fergus

PY - 2004/11

Y1 - 2004/11

N2 - OBJECTIVE. The purpose of this investigation was to explore the clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. MATERIALS AND METHODS. We retrospectively identified 127 patients who underwent contemporaneous contrast-enhanced CT of the chest or abdomen and echocardiography. On CT, the presence of retrograde inferior vena cava or hepatic vein opacification and the rate of IV contrast injection (> 3 mL/sec, high; ≤ 3 mL/sec, low) were recorded. On echocardiography, the presence of tricuspid regurgitation, pulmonary hypertension, or right ventricular systolic dysfunction was recorded. RESULTS. Retrograde inferior vena cava or hepatic vein opacification was more common in studies performed with a high rather than a low contrast injection rate (28/56 vs 6/71 patients, respectively; p <0.01). This finding was 31% sensitive (5/16) and 98% specific (54/55) for right-sided heart disease at low contrast injection rates, and 81% sensitive (17/21) and 69% specific (24/35) at high injection rates. Multivariate logistic regression models showed that high injection rate, tricuspid regurgitation, pulmonary hypertension, and right ventricular systolic dysfunction were independent predictors of retrograde inferior vena cava or hepatic vein opacification (p <0.05 for each). CONCLUSION. Retrograde opacification of the inferior vena cava or hepatic veins on CT is a specific but insensitive sign of right-sided heart disease at low contrast injection rates, but the usefulness of this classic sign decreases with high injection rates. This realization is important because many centers increasingly use high-injection-rate CT.

AB - OBJECTIVE. The purpose of this investigation was to explore the clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. MATERIALS AND METHODS. We retrospectively identified 127 patients who underwent contemporaneous contrast-enhanced CT of the chest or abdomen and echocardiography. On CT, the presence of retrograde inferior vena cava or hepatic vein opacification and the rate of IV contrast injection (> 3 mL/sec, high; ≤ 3 mL/sec, low) were recorded. On echocardiography, the presence of tricuspid regurgitation, pulmonary hypertension, or right ventricular systolic dysfunction was recorded. RESULTS. Retrograde inferior vena cava or hepatic vein opacification was more common in studies performed with a high rather than a low contrast injection rate (28/56 vs 6/71 patients, respectively; p <0.01). This finding was 31% sensitive (5/16) and 98% specific (54/55) for right-sided heart disease at low contrast injection rates, and 81% sensitive (17/21) and 69% specific (24/35) at high injection rates. Multivariate logistic regression models showed that high injection rate, tricuspid regurgitation, pulmonary hypertension, and right ventricular systolic dysfunction were independent predictors of retrograde inferior vena cava or hepatic vein opacification (p <0.05 for each). CONCLUSION. Retrograde opacification of the inferior vena cava or hepatic veins on CT is a specific but insensitive sign of right-sided heart disease at low contrast injection rates, but the usefulness of this classic sign decreases with high injection rates. This realization is important because many centers increasingly use high-injection-rate CT.

UR - http://www.scopus.com/inward/record.url?scp=16544369440&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16544369440&partnerID=8YFLogxK

M3 - Article

VL - 183

SP - 1227

EP - 1232

JO - AJR. American journal of roentgenology

JF - AJR. American journal of roentgenology

SN - 0361-803X

IS - 5

ER -