EURORAD ESR

Case 13386

Post-infarction full-thickness myocardial rupture: a life-saving CT diagnosis

Author(s)
Tonolini Massimo* 1, Damiani Guglielmo 1, Ippolito Sonia 1, Lemma Massimo 2

(1) Department of Radiology, (2) Cardiothoracic Surgery
“Luigi Sacco” University Hospital, Via G.B. Grassi 74, 20157 Milan - Italy
* Email:mtonolini@sirm.org
 
Patient
male, 67 year(s)
 
 
  • Figure 1
    Emergency multidetector CT of thorax and abdomen
     

    Coronal reconstructed image from preliminary unenhanced acquisition revealed hyperattenuating (55 Hounsfield units) pericardial effusion (+) consistent with hemopericardium.

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Arterial-phase enhanced acquisition with bolus tracking technique showed contrast medium (*) extravasation through a full-thickness breach (Arrow) of the lateral wall of the left ventricle. Note hemopericardium(+),...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;

    Additional venous phase acquisition showed increased opacification of the pericardial effusion (*) by contrast extravasation through the full-thickness rupture of the left ventricular myocardium (Arrow). Note...

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;
     
     
Coronal reconstructed image from preliminary unenhanced acquisition revealed hyperattenuating (55 Hounsfield units) pericardial effusion (+) consistent with hemopericardium.
 
Arterial-phase enhanced acquisition with bolus tracking technique showed contrast medium (*) extravasation through a full-thickness breach (Arrow) of the lateral wall of the left ventricle. Note hemopericardium(+), intra-aortic balloon pump(arrowhead).
 
Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.Note hemopericardium (+).
 
Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.
 
Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.Note hemopericardium (+).
 
Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.
 
Additional venous phase acquisition showed increased opacification of the pericardial effusion (*) by contrast extravasation through the full-thickness rupture of the left ventricular myocardium (Arrow). Note hemopericardium (+).
 
 
 
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