91 inferior vena cava (ivc) filling

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91 Inferior Vena Cava (IVC) Filling Defects

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91 Inferior Vena Cava (IVC) Filling Defects

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 91-1 Laminar flow artifact. (A) Axial enhanced CT image shows a filling defect (arrow) caused by inflow of opacified blood from the renal veins mixing with poorly opacified blood in the IVC. (B) Curved multiplanar image reveals opacified blood from the renal veins streaming into the IVC (arrows), illustrating how the axial image can show an apparent IVC filling defect.201

• Fig GI 91-2 Artifact due to high injection rate. Early arterial phase CT image shows an IVC filling defect (arrowhead) due to laminar flow of refluxed contrast from the hepatic veins. Bright enhancement in the hepatic veins (arrows) is seen because of reflux of contrast from the heart.201

• Fig GI 91-3 Bland thrombus. (A) Axial enhanced CT image before IVC filter placement shows bland thrombus (arrow) in the IVC. (B) Coronal multiplanar image reconstructed from CT data after IVC filter placement shows extension of bland thrombus into both renal veins (arrowheads) and the infrahepatic portion of the IVC. Note the IVC filter (arrow) and decreased enhancement of the right kidney due to hypoperfusion

• Fig GI 91-4 Bland and tumor thrombus. Coronal T1-weighted MR image reveals bland thrombus (arrowheads) that formed inferior relative to tumor thrombus (arrows) in the infrahepatic portion of the IVC. The low-signal-intensity lesion in the right kidney (*) represented renal cell carcinoma.201

• Fig GI 91-5 Renal cell carcinoma. Axial T2-weighted MR image with fat saturation shows a large, right renal mass (arrowheads) with heterogeneous high signal intensity. Note the tumor thrombus in the adjacent portion of the IVC (arrow).201

Fig GI 91-6 Leiomyosarcoma. Contrast CT scan demonstrates a heterogeneously enhancing mass (arrow) that arose in the IVC.201