On putative arterial and portal venous phases, concentrated contrast medium lies in the right subclavian vein, azygos arch, azygos vein, right atrium, with reflux into the coronary sinus, infrahepatic IVC, middle/right hepatic veins and multiple hepatic venous tributaries throughout the posterior peripheral liver, and also into the right renal vein and its intrarenal tributaries. Contrast in the left atrium from a direct interatrial communication between the two atria via a septal opening, ASD vs PFO. Small amount of contrast medium also in the left ventricle. Contrast medium also extends from the left atrium into several pulmonary veins.
No contrast medium in the pulmonary arteries, aorta or arterial side of the systemic circulation.
Further meaningful evaluation of the hepatic lesion cannot be performed.
Interval enlargement moderate right pleural effusion and very small left-sided effusion with bilateral atelectasis and subtotal consolidation of the right lower lobe. Suspicion of pulmonary honeycombing.
Conclusion:
Cardiac arrest during a CT results in this characteristic pattern of contrast opacification secondary to reflux into the IVC and also into the left atrium ? PFO.