Dynamic Contrast-Enhanced CT of the Abdomen to Predict Clinical Prognosis in Patients With Hypovolemic Shock

Abstract

The objective of our study was to investigate the value of dynamic contrast-enhanced CT (DCE-CT) findings in predicting the clinical prognosis of patients with hypovolemic shock. This study included 33 patients with hypovolemic shock who underwent DCE-CT of the abdomen due to trauma. The CT attenuation values of several abdominal organs (spleen, liver, pancreas, kidneys [cortex and medulla], adrenal gland) in patients with hypovolemic shock were measured in the early phase and delayed phase to compare the differences in contrast enhancement effects between the survival group and the deceased group. Among the 33 patients with hypovolemic shock, 15 patients died (deceased group) within 5 weeks (mean, 6 days). The remaining 18 patients survived and recovered (survival group). The mean CT attenuation values of the renal medulla in the delayed phase CT in the deceased group (155.4 ± 60.1 [SD] HU) were significantly lower (p = 0.001) than those in the survival group (227.3 ± 47.3 HU). The mean CT attenuation values of the renal medulla in the early phase CT did not show a significant difference between the two groups (102.4 ± 61.7 vs 113.9 ± 43.5 HU, respectively). The mean CT values of the spleen in the early phase CT in the deceased group (90.8 ± 26.0 HU) were significantly lower (p = 0.015) than those in the survival group (119.9 ± 33.9 HU). Regarding other CT measurements, there were no other significant differences between the deceased group and survival group. Decreased enhancement of the renal medulla in the delayed phase and decreased enhancement of the spleen in the early phase are useful CT findings to predict a poor clinical prognosis in patients with hypovolemic shock.