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Imaging findings of acute intravascular thrombus on non-enhanced computed tomography

Ryan T Whitesell1, Scott D Steenburg

  • 1Department of Radiology and Imaging Sciences, Indiana University Health Methodist Hospital, 1701 N. Senate Blvd, Room AG-176, Indianapolis, IN, 46202, USA.

Emergency Radiology
|March 22, 2014
PubMed

Insights

Acute intravascular thrombosis can be detected on non-contrast CT scans. The "hyperdense vessel sign" indicates increased clot density, aiding diagnosis in various body regions and prompting further imaging.

Area of Science:

  • Radiology
  • Medical Imaging

Background:

  • Intravascular thrombosis and thromboembolism are critical diagnoses.
  • Contrast-enhanced computed tomography (CECT) and Doppler ultrasound are common diagnostic tools.
  • Non-contrast CT (NECT) is sometimes used for acute intravascular pathology.

Purpose of the Study:

  • To review the appearance of acute intravascular thrombosis on NECT.
  • To highlight the utility of the "hyperdense vessel sign" on NECT.

Main Methods:

  • Pictorial review of NECT scans.
  • Focus on the hyperdense vessel sign in acute thrombosis.

Main Results:

  • Acute thrombus appears hyperdense (increased Hounsfield unit density) on NECT compared to the blood pool.
  • This sign is applicable to arterial and venous thrombosis in the chest, abdomen, pelvis, and extremities, not just stroke.
  • NECT can suggest or aid in the diagnosis of intravascular thrombosis.

Conclusions:

  • The hyperdense vessel sign on NECT is a valuable indicator of acute intravascular thrombosis.
  • NECT can be a useful initial imaging modality for suspected thrombosis, guiding further diagnostic workup.

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