TY - JOUR
T1 - Retrospective analysis of intravertebral collateral enhancement in patients with central venous obstruction
AU - Simeone, F. Joseph
AU - Bennett, Debbie L.
AU - Chang, Connie Y.
AU - Huang, Ambrose J.
AU - Kattapuram, Susan V.
AU - Bredella, Miriam A.
AU - Torriani, Martin
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: To compare prevalence and patterns of intravertebral collateral enhancement in patients with and without central venous obstruction (CVO). Materials and methods: Chest CTs performed between 1/1/2000 and 12/15/2012 with reports containing terms indicating CVO were identified. All contrast enhanced CTs were examined for the presence of CVO and collateral venous pathways. If intravertebral collateral enhancement was present, the pattern was recorded as nodular, linear, or both. Results: In 209 suspected cases of CVO, 53 (25 %) were confirmed with obstruction and 156 (75 %) were without obstruction. In patients with CVO, 47 % (25/53) demonstrated collateral venous flow through an intravertebral marrow pathway compared to 5 % (8/156) of patients without CVO (P < 0.0001). The most common level of enhancement was the upper thoracic spine, involving only the vertebral body. Nodular, linear, and combined nodular-linear enhancement patterns were seen with similar frequency. Nodular intravertebral collateral enhancement was mistaken for sclerotic metastases in 33 % (3/9) of cases. Conclusion: Intravertebral collateral enhancement was seen in almost half the patients with CVO and when nodular enhancement is present, it is important to differentiate between metastatic lesions and enhancement related to CVO.
AB - Objective: To compare prevalence and patterns of intravertebral collateral enhancement in patients with and without central venous obstruction (CVO). Materials and methods: Chest CTs performed between 1/1/2000 and 12/15/2012 with reports containing terms indicating CVO were identified. All contrast enhanced CTs were examined for the presence of CVO and collateral venous pathways. If intravertebral collateral enhancement was present, the pattern was recorded as nodular, linear, or both. Results: In 209 suspected cases of CVO, 53 (25 %) were confirmed with obstruction and 156 (75 %) were without obstruction. In patients with CVO, 47 % (25/53) demonstrated collateral venous flow through an intravertebral marrow pathway compared to 5 % (8/156) of patients without CVO (P < 0.0001). The most common level of enhancement was the upper thoracic spine, involving only the vertebral body. Nodular, linear, and combined nodular-linear enhancement patterns were seen with similar frequency. Nodular intravertebral collateral enhancement was mistaken for sclerotic metastases in 33 % (3/9) of cases. Conclusion: Intravertebral collateral enhancement was seen in almost half the patients with CVO and when nodular enhancement is present, it is important to differentiate between metastatic lesions and enhancement related to CVO.
KW - Central venous obstruction
KW - Collateral venous pathways
KW - Intravertebral collateral enhancement
KW - Vena cava obstruction
UR - http://www.scopus.com/inward/record.url?scp=84951905587&partnerID=8YFLogxK
U2 - 10.1007/s00256-015-2274-6
DO - 10.1007/s00256-015-2274-6
M3 - Article
C2 - 26497542
AN - SCOPUS:84951905587
SN - 0364-2348
VL - 45
SP - 163
EP - 168
JO - Skeletal Radiology
JF - Skeletal Radiology
IS - 2
ER -