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Mediastinal widening--a valuable radiographic sign of superior vena cava thrombosis

G Brown1, J E Husband

  • 1Department of Radiology, Royal Marsden Hospital, Sutton, Surrey.

Clinical Radiology
|June 1, 1993
PubMed

Insights

Mediastinal widening on chest X-rays is a key indicator of superior vena cava (SVC) thrombosis in patients with Hickman catheters. Recognizing this sign aids in earlier diagnosis and treatment of catheter-related SVC obstruction.

Area of Science:

  • Radiology
  • Vascular Surgery
  • Oncology

Background:

  • Indwelling intravenous catheters, such as Hickman catheters, are increasingly associated with superior vena cava (SVC) thrombosis.
  • SVC thrombosis can lead to benign SVC obstruction, a condition requiring prompt recognition.

Purpose of the Study:

  • To evaluate the radiographic findings of SVC thrombosis in patients with Hickman catheter insertion.
  • To determine the utility of mediastinal widening as an early diagnostic sign of SVC thrombosis.

Main Methods:

  • Retrospective review of PA chest radiographs from nine patients with SVC thrombosis secondary to Hickman catheter placement.
  • Analysis of radiographic signs, including mediastinal widening and catheter displacement, in relation to symptom onset.

Main Results:

  • All nine patients exhibited mediastinal widening concurrent with SVC thrombosis.
  • Four patients showed radiographic signs of SVC thrombosis before symptom manifestation.
  • Lateral displacement of the Hickman catheter was observed in five patients.

Conclusions:

  • Superior mediastinal widening is a significant radiographic marker for SVC thrombosis in patients with Hickman catheters.
  • Early detection of mediastinal widening can facilitate earlier diagnosis and intervention for SVC thrombosis.

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