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Case Reports
. 2020 Jan 15;15(3):302-305.
doi: 10.1016/j.radcr.2019.12.023. eCollection 2020 Mar.

Computed tomography venography of the upper extremities - Using low dose bilateral contrast media injection in a patient with suspected venous thoracic outlet syndrome

Anders Svensson  1   2 , Torkel B Brismar  1   2 , Katharina Brehmer  1   2
Affiliations
Case Reports

Computed tomography venography of the upper extremities - Using low dose bilateral contrast media injection in a patient with suspected venous thoracic outlet syndrome

Anders Svensson et al. Radiol Case Rep. .

Abstract

Venous thoracic outflow syndrome may occur as a result from compression of the subclavian and/or axillary vein and consequently, decreased blood flow and increased risk of thrombus formation. A previously healthy 34-year-old woman who, after intensive crossfit training, experienced sudden intense pain and swelling in her right upper arm was referred for computed tomography of her right upper arm and thoracic veins. The computed tomography was performed using bilateral injection of low dose, diluted contrast medium. The computed tomography venography revealed an elongated contrast medium embraced thrombus in the right subclavian and axillary vein. By using a dual injection consisting of diluted contrast medium, artifact-free visualization of arm veins and sufficient enhancement of thoracic veins can be achieved.

Keywords: Computed tomography venography; Contrast agents-intravenous; Ct; Upper extremities.

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Figures

Fig 1
Fig. 1
Coronar projection showing an elongated contrast media (CM) embraced thrombus in the right subclavian and axillary vein (arrows).
Fig 2
Fig. 2
Volume rendering image (VR) showing constriction of the right subclavian vein (arrows).
Fig 3
Fig. 3
VR image showing generated collateral vessels in the right upper extremity (arrows).
Fig 4
Fig. 4
VR image showing simultaneous bilateral CM injection providing sufficient enhancement of the arm veins bilaterally, right and left brachiocephalic vein, and superior vena cava.
See this image and copyright information in PMC

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