Kim H J, Kim H S, Chung S H
Department of Diagnostic Radiology, Gyeongsang National University Hospital, Chinju, Korea.
AJR Am J Roentgenol. 1993 Sep;161(3):539-42. doi: 10.2214/ajr.161.3.8352099.
The purpose of this study was to evaluate the importance of collateral vessels in the CT diagnosis of superior vena cava syndrome.
Forty-seven patients with CT evidence of obstruction or compression of the superior vena cava or its major tributaries were included in this study. Contrast-enhanced CT scans had been obtained with a combined bolus and drip-infusion technique. We evaluated the CT scans, with particular attention to the presence of collateral vessels (and if present, their location), without knowing the patients' clinical histories. On reviewing the patients' charts, we found 23 patients with signs or symptoms of superior vena cava syndrome. We then correlated the presence of collateral vessels with the presence of signs and symptoms of superior vena cava syndrome. To verify the frequency of visible collateral vessels in healthy subjects, we also evaluated CT scans of 50 control subjects who did not have mediastinal disease or signs and symptoms of superior vena cava syndrome.
Collateral vessels were seen on CT scans in 24 patients. Among the 23 patients who had signs and symptoms of superior vena cava syndrome, 22 patients had CT scans that showed collateral vessels. Two cases were false-positive and one was false-negative. The presence of collateral vessels, regardless of the number and location of the vessels shown on CT scans, was highly accurate as a predictor of superior vena cava syndrome, with a sensitivity of 96% and a specificity of 92%. Collateral vessels were seen in three (6%) of the 50 control subjects.
We conclude that the presence of collateral vessels is a highly sensitive and specific CT sign of superior vena cava syndrome.
本研究旨在评估侧支血管在CT诊断上腔静脉综合征中的重要性。
本研究纳入了47例CT显示上腔静脉或其主要分支存在梗阻或受压的患者。采用团注加滴注技术进行了增强CT扫描。我们在不了解患者临床病史的情况下评估CT扫描结果，特别关注侧支血管的存在情况（若存在，其位置）。在查阅患者病历后，我们发现23例有上腔静脉综合征的体征或症状。然后我们将侧支血管的存在情况与上腔静脉综合征的体征和症状进行关联。为了验证健康受试者中可见侧支血管的频率，我们还评估了50例无纵隔疾病且无上腔静脉综合征体征和症状的对照受试者的CT扫描结果。
2�例患者的CT扫描显示有侧支血管。在23例有上腔静脉综合征体征和症状的患者中，22例患者的CT扫描显示有侧支血管。2例为假阳性，1例为假阴性。无论CT扫描显示的侧支血管数量和位置如何，侧支血管的存在作为上腔静脉综合征的预测指标具有高度准确性，敏感性为96%，特异性为92%。50例对照受试者中有3例（6%）可见侧支血管。
我们得出结论，侧支血管的存在是上腔静脉综合征高度敏感和特异的CT征象。
