Catalano Orlando, de Lutio di Castelguidone Elisabetta, Sandomenico Claudia, Petrillo Mario, Aprea Pasquale, Granata Vincenza, D'Errico Adolfo Gallipoli
Department of Radiology, National Cancer Institute “Fondazione G Pascale" Naples, Italy.
Acta Radiol. 2011 Mar 1;52(2):148-54. doi: 10.1258/ar.2010.100294.
Venous thrombosis is a common occurrence in cancer patients, developing spontaneously or in combination with indwelling central venous devices (CVD).
To analyze the multidetector CT (MDCT) prevalence, appearance, and significance of catheter-related thoracic venous thrombosis in oncologic patients and to determine the percentage of thrombi identified in the original reports.
Five hundred consecutive patients were considered. Inclusion criteria were: presence of a CVD; availability of a contrast-enhanced MDCT; and cancer history. Exclusion criteria were: direct tumor compression/infiltration of the veins; poor image quality; device tip not in the scanned volume; and missing clinical data. Seventeen (3.5%) out of the final 481 patients had a diagnosis of venous thrombosis.
Factors showing the highest correlation with thrombosis included peripherally-inserted CVD, right brachiocephalic vein tip location, patient performance status 3, metastatic stage disease, ongoing chemotherapy, and longstanding CVD. The highest prevalence was in patients with lymphoma, lung carcinoma, melanoma, and gynecologic malignancies. Eleven out of 17 cases had not been identified in the original report.
CVD-related thrombosis is not uncommon in cancer patients and can also be observed in outpatients with a good performance status and a non-metastatic disease. Thrombi can be very tiny. Radiologists should be aware of the possibility to identify (or overlook) small thrombi.
