Central venous occlusion: MR angiography

The authors evaluated time-of-flight magnetic resonance (MR) angiography in 30 patients with suspected thoracic venous occlusion. The results of the MR studies were compared with results at contrast venography in 22 patients and at central venous cannulation in seven of the remaining eight patients. Twenty-eight patients had abnormalities on MR venograms; 21 of these abnormalities involved multiple veins. Eight patients had superior vena cava (SVC) occlusion with retrograde azygos blood flow, and two patients had nonocclusive SVC thrombus. Fifteen patients had thrombosis involving the brachiocephalic veins; 14, involving the subclavian veins; and eight, involving the internal jugular veins. Correlation was excellent between findings of venous obstruction and occlusion at contrast venography and MR angiography. MR imaging provided more comprehensive information than catheter venography on central venous anatomy and blood flow. For evaluation of central veins, MR angiography is an accurate and graphic technique that may succeed in cases in which other methods may give inadequate findings or may be impossible to perform.