Altered flow dynamics of intravascular contrast material to the liver in superior vena cava syndrome: CT findings.
BACKGROUND
To evaluate the findings of altered flow dynamics in the livers of patients with obstruction of superior vena cava (SVC) on helical computed tomography (CT).


METHODS
In six patients (age range = 28-80 years) with SVC obstruction, CT findings were retrospectively reviewed to identify the abnormal enhancement patterns of the liver and the relation with the extrahepatic collateral vessels and hepatic vessels.


RESULTS
Abnormal hepatic enhancement was observed in the following four (A-D) portions: (A) anterior portion of segment IV (n = 5), (B) subdiaphragmatic portion of the liver (n = 4), (C) posterior portion of the right lobe (bare area; n = 1), and (D) lateral segment of the left lobe (n = 2). Two major collateral pathways to the liver were demonstrated as follows: A and D --> from the umbilical vein to the left portal vein, and B and C --> from the subcapsular vein to the bare area of the liver or to the hepatic veins. On helical CT, these collateral pathways were also clearly visualized.


CONCLUSIONS
When these abnormal enhancements of the liver on CT are recognized within the liver, these findings indicate diversion of contrast material into collateral pathways to the liver with SVC obstruction.
Baba
Y
Y
Department of Radiology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Miyazono
N
N
Inoue
H
H
Kanetsuki
I
I
Niwatsukino
H
H
Tanaka
D
D
Nishi
H
H
Nandate
T
T
Ohkubo
K
K
Nakajo
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003097:Collateral Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011169:Portal Vein / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media