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Skeletal Radiology
Published in: Skeletal Radiology 2/2016

01-02-2016 | Scientific Article

Retrospective analysis of intravertebral collateral enhancement in patients with central venous obstruction

Authors: F. Joseph Simeone, Debbie L. Bennett, Connie Y. Chang, Ambrose J. Huang, Susan V. Kattapuram, Miriam A. Bredella, Martin Torriani

Published in: Skeletal Radiology | Issue 2/2016

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Abstract

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.
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Metadata
Title
Retrospective analysis of intravertebral collateral enhancement in patients with central venous obstruction
Authors
F. Joseph Simeone
Debbie L. Bennett
Connie Y. Chang
Ambrose J. Huang
Susan V. Kattapuram
Miriam A. Bredella
Martin Torriani
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 2/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2274-6

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