When beauty hides a beast

H Devos, L Goethals, D E Verdries, K De Smet, F De Geeter, J De Mey

Research output: Contribution to journalJournal articleResearchpeer-review


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.
Original languageEnglish
JournalJBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
Issue number3
Pages (from-to)192-193
Publication statusPublished - 17. Sep 2014
Externally publishedYes


  • Adult
  • Angiography
  • Diagnosis, Differential
  • Diagnostic Errors
  • False Negative Reactions
  • Female
  • Heart Failure
  • Humans
  • Pulmonary Artery
  • Pulmonary Embolism
  • Radiographic Image Enhancement
  • Tomography, X-Ray Computed
  • Ventricular Dysfunction, Right
  • Angiography/methods
  • Heart Failure/diagnostic imaging
  • Pulmonary Artery/diagnostic imaging
  • Tomography, X-Ray Computed/methods
  • Ventricular Dysfunction, Right/diagnostic imaging
  • Radiographic Image Enhancement/methods
  • Diagnostic Errors/prevention & control
  • Pulmonary Embolism/diagnostic imaging


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