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Related Experiment Videos

Thoracic collateral venous channels: normal and pathologic CT findings.

J P Trigaux1, B Van Beers

  • 1Department of Radiology, Cliniques Universitaires de Mont-Godinne (UCL), Yvoir, Belgium.

Journal of Computer Assisted Tomography
|September 1, 1990
PubMed
Summary

Opacification of thoracic collateral venous channels on chest CT can indicate superior vena cava (SVC) obstruction. However, only the subcutaneous anterior channel offers high specificity for diagnosing SVC syndrome.

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Area of Science:

  • Radiology
  • Vascular Imaging
  • Thoracic Imaging

Background:

  • Opacification of thoracic collateral venous channels (CVC) is a recognized indicator of superior vena cava (SVC) obstruction.
  • The diagnostic specificity of CVC opacification for SVC obstruction has been questioned.

Purpose of the Study:

  • To compare the diagnostic accuracy of various thoracic CVC opacification for SVC obstruction.
  • To identify specific CVCs with higher diagnostic value in SVC syndrome.

Main Methods:

  • A dynamic incremental CT technique with bolus injection was employed.
  • The degree of opacification of six different thoracic CVCs was assessed.
  • A study group of 36 patients with SVC syndrome and a control group of 50 patients were analyzed.

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Main Results:

  • Opacification of any CVC showed low diagnostic accuracy (34% false-positive, 31% false-negative).
  • Opacification of the subcutaneous anterior channel demonstrated high specificity (96%) for SVC obstruction.
  • This specificity was significantly greater than that of posterior collateral channels (p < 0.05).

Conclusions:

  • Opacification of the subcutaneous anterior channel on chest CT is a reliable indicator for suspecting SVC obstruction.
  • In cases with equivocal clinical signs or other CT findings, this sign warrants further investigation with cavography.