EURORAD ESR

Case 14867

Implantable vascular port-associated thrombophlebitis

Author(s)
Tonolini Massimo, MD

"Luigi Sacco" University Hospital,
Radiology Department;
Via G.B. Grassi 74
20157 Milan, Italy;
Email:mtonolini@sirm.org
 
Patient
female, 55 year(s)
 
 
  • Figure 1
    Chest radiographs
     

    The implanted vascular port includes a subcutaneous device connected to a right subclavian central venous catheter with its distal part (thick arrows) located in the superior vena cava. Note minimal right-sided...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: Plain radiographic studies; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    The implanted vascular port includes a subcutaneous device connected to a right subclavian central venous catheter with its distal part (thick arrows) located in the superior vena cava. Note minimal right-sided...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: Plain radiographic studies; Procedure: Complications; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 2
    Colour Doppler ultrasound
     

    Transverse (a) and longitudinal (b) images showed dilated, noncompressible right internal jugular vein (arrows), entirely occupied by echogenic thrombus.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Transverse (a) and longitudinal (b) images showed dilated, noncompressible right internal jugular vein (arrows), entirely occupied by echogenic thrombus.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Similarly, the ipsilateral subclavian vein (thin arrows) showed complete luminal occupation by echogenic thrombus, without detectable flow.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Complications; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 3
    Contrast-enhanced multidetector CT of neck and chest
     

    Panoramic coronal image showed catheter tip (thick arrow) correctly positioned in the normally opacified, patent superior vena cava; absent luminal opacification of right subclavian (thin arrows) and internal jugular...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Axial images (b...f in craniocaudal order) confirmed absent luminal opacification of internal jugular vein (arrows) with minimally thickened hyperenhancing venous wall suggesting septic nature of occlusive thrombosis.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Axial images (b...f in craniocaudal order) confirmed absent luminal opacification of internal jugular vein (arrows) with minimally thickened hyperenhancing venous wall suggesting septic nature of occlusive thrombosis.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    The non-opacified right internal jugular vein (arrows) showed minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat planes (*) suggesting septic nature of occlusive...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Similarly, the right subclavian vein (thin arrows) showed non-opacified lumen, minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat (*) suggesting septic nature of...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;

    Similarly, the right subclavian vein (thin arrows) showed non-opacified lumen, minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat (*) suggesting septic nature of...

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Complications; Special Focus: Embolism / Thrombosis;
     
     
The implanted vascular port includes a subcutaneous device connected to a right subclavian central venous catheter with its distal part (thick arrows) located in the superior vena cava. Note minimal right-sided pleural effusion, absent pneumothorax.
 
The implanted vascular port includes a subcutaneous device connected to a right subclavian central venous catheter with its distal part (thick arrows) located in the superior vena cava. Note minimal right-sided pleural effusion, absent pneumothorax.
 
Transverse (a) and longitudinal (b) images showed dilated, noncompressible right internal jugular vein (arrows), entirely occupied by echogenic thrombus.
 
Transverse (a) and longitudinal (b) images showed dilated, noncompressible right internal jugular vein (arrows), entirely occupied by echogenic thrombus.
 
Similarly, the ipsilateral subclavian vein (thin arrows) showed complete luminal occupation by echogenic thrombus, without detectable flow.
 
Panoramic coronal image showed catheter tip (thick arrow) correctly positioned in the normally opacified, patent superior vena cava; absent luminal opacification of right subclavian (thin arrows) and internal jugular vein (arrows) consistent with occlusive thrombosis.
 
Axial images (b...f in craniocaudal order) confirmed absent luminal opacification of internal jugular vein (arrows) with minimally thickened hyperenhancing venous wall suggesting septic nature of occlusive thrombosis.
 
Axial images (b...f in craniocaudal order) confirmed absent luminal opacification of internal jugular vein (arrows) with minimally thickened hyperenhancing venous wall suggesting septic nature of occlusive thrombosis.
 
The non-opacified right internal jugular vein (arrows) showed minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat planes (*) suggesting septic nature of occlusive thrombosis.
 
Similarly, the right subclavian vein (thin arrows) showed non-opacified lumen, minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat (*) suggesting septic nature of occlusive thrombosis.
 
Similarly, the right subclavian vein (thin arrows) showed non-opacified lumen, minimally thickened hyperenhancing venous wall and inflammatory hyperattenuation of surrounding fat (*) suggesting septic nature of occlusive thrombosis. Note port catheter (thick arrow).
 
 
 
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