Article Data

  • Views 1932
  • Dowloads 47

Original Research

Open Access

Measurement of the diameter and area of the inferior vena cava using computed tomography and its relationship with intravascular volume

  • Eren Mingsar1,*,

1Internal Medicine Intensive Care Unit, İzmir Katip Çelebi University Atatürk Education and Research Hospital, 35620 Izmir, Türkiye

DOI: 10.22514/sv.2025.164

Submitted: 22 April 2025 Accepted: 01 September 2025

Online publish date: 30 October 2025

*Corresponding Author(s): Eren Mingsar E-mail: eren.mingsar@deu.edu.tr

Abstract

Background: Accurate assessment of intravascular volume status is critical in intensive care management. Conventional methods may have limitations in precision and availability. Computed tomography (CT) offers the opportunity to measure the diameter and cross-sectional area of the inferior vena cava (IVC), potentially providing an alternative tool for fluid evaluation. Methods: This diagnostic investigation was conducted in the Internal Medicine Intensive Care Unit between 2022 and 2023. A total of 105 patients diagnosed with pneumonia were enrolled. Standardized CT imaging was performed for each participant, with measurements obtained at predetermined thoracic anatomical levels. Clinical indicators of fluid status, including pleural effusion and brain natriuretic peptide (BNP) levels, were recorded for comparison. Results: CT-based measurements of IVC diameter and area demonstrated statistically significant correlations with conventional indicators of intravascular volume status. Both pleural effusion and BNP levels were closely associated with the imaging parameters, thereby confirming their clinical relevance. Conclusions: CT measurements of the IVC provide a reliable, non-invasive approach to assessing intravascular volume in critically ill patients. This method holds promise for improving fluid management strategies in intensive care practice, offering an effective adjunct to traditional evaluation techniques.


Keywords

Inferior vena cava; Computed tomography; Intravascular volume; Pleural effusion; B type natriuretic peptide


Cite and Share

Eren Mingsar. Measurement of the diameter and area of the inferior vena cava using computed tomography and its relationship with intravascular volume. Signa Vitae. 2025. doi: 10.22514/sv.2025.164

References

[1] Ivey-Miranda JB, Wetterling F, Gaul R, Sheridan S, Asher JL, Rao VS, et al. Changes in inferior vena cava area represent a more sensitive metric than changes in filling pressures during experimental manipulation of intravascular volume and tone. European Journal of Heart Failure. 2022; 24: 455–462.

[2] Lee GH, Choi JW. Initial assessment of hemorrhagic shock by trauma computed tomography measurement of the inferior vena cava in blunt trauma patients. Journal of Trauma and Injury. 2022; 35: 181–188.

[3] NICE. Chronic heart failure in adults: management. 2024. Available at: https://www.nice.org.uk/guidance/cg108 (Accessed: 24 February 2024).

[4] Matthay MA, Arabi Y, Arroliga AC, Bernard G, Bersten AD, Brochard LJ. A new global definition of acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine. 2024; 209: 37–47.

[5] de Carvalho EB, Battaglini D, Robba C, Malbrain MLNG, Pelosi P, Rocco PRM, et al. Fluid management strategies and their interaction with mechanical ventilation: from experimental studies to clinical practice. Intensive Care Medicine Experimental. 2023; 11: 44.

[6] Shah P, Louis MA. Physiology, central venous pressure. 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519493/ (Accessed: 12 March 2024).

[7] Istrail L, Kiernan J, Stepanova M. A novel method for estimating right atrial pressure with point-of-care ultrasound. Journal of the American Society of Echocardiography. 2023; 36: 278–283.

[8] Egbe AC, Connolly HM, Pellikka PA, Anderson JH, Miranda WR. Role of inferior vena cava dynamics for estimating right atrial pressure in congenital heart disease. Circulation: Cardiovascular Imaging. 2022; 15: e014308.

[9] Kaptein EM, Kaptein MJ. Inferior vena cava ultrasound and other techniques for assessment of intravascular and extravascular volume: an update. Clinical Kidney Journal. 2023; 16: 1861–1877.

[10] Millington SJ, Koenig S. Ultrasound assessment of the inferior vena cava for fluid responsiveness: making the case for skepticism. Journal of Intensive Care Medicine. 2021; 36: 1223–1227.

[11] Monnet X, Marik P, Teboul JL. Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis. Intensive Care Medicine. 2016; 42: 1935–1947.

[12] Sondergaard S. A critical review of the hemodynamics in assessment of volume responsiveness by using passive leg raising (PLR). Trends in Anaesthesia and Critical Care. 2023; 53: 101292.

[13] Di Nicolò P, Tavazzi G, Nannoni L, Corradi F. Inferior vena cava ultrasonography for volume status evaluation: an intriguing promise never fulfilled. Journal of Clinical Medicine. 2023; 12: 2217.

[14] Lee DJW, Aw TC. Natriuretic peptides in clinical practice: a current review. Journal of Immunological Sciences. 2023; 7: 28–34.

[15] Tsutsui H, Albert NM, Coats AJS, Anker SD, Bayes-Genis A, Butler J, et al. Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society. European Journal of Heart Failure. 2023; 25: 616–631.

[16] Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart failure with preserved ejection fraction: JACC scientific statement. Journal of the American College of Cardiology. 2023; 81: 1810–1834.

[17] Komiya K, Ishii H, Murakami J, Yamamoto H, Okada F, Satoh K, et al. Comparison of chest computed tomography features in the acute phase of cardiogenic pulmonary edema and acute respiratory distress syndrome on arrival at the emergency department. Journal of Thoracic Imaging. 2013; 28: 322–328.

[18] Barbas CSV. Thoracic computed tomography to assess ARDS and COVID-19 lungs. Frontiers in Physiology. 2022; 13: 829534.


Submission Turnaround Time

Top