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Yang Q, Xu J, Zhou J, Liu Q, Mai Z, Xie H, Ban X, Liu L, Zhang R. Feasible CT features to distinguish incidental rib enhancement from sclerotic metastasis in patients with malignancies. Skeletal Radiol 2024; 53:1507-1515. [PMID: 38363418 PMCID: PMC11194195 DOI: 10.1007/s00256-024-04609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To investigate the CT features of incidental rib enhancement (RE) and to summarize the CT characteristics for distinguishing the RE from sclerotic metastasis (SM) in patients with malignancies. MATERIAL AND METHODS This retrospective observational study enrolled 79 patients with RE (involved 133 ribs) during October 2014 and December 2021. Another 53 patients with SM (160 SM) in the same period were selected randomly for comparison. The location, enhancement patterns of RE were reviewed. The CT values of RE regions and SM were measured and statistically analyzed. RESULTS Most REs (70 patients, 88.6%) were in the 1st to 6th ribs. 50 patients had solitary RE and 29 with multiple REs in a regional distribution. All the REs were closely connected to the intercostal venous plexus (ICVP) ipsilateral to the injection site. No visible abnormalities on unenhanced scans were detected in all REs. One hundred and twenty REs (90.2%) had nodular/patchy enhancement. The CT value of RE regions in the venous phase was lower than that in the arterial phase (589.8 ± 344.2 HU versus 1188.5 ± 325.3 HU, p < 0.001). During the venous phase, most REs (125, 94.0%) shrank or disappeared. SM appeared similar on both contrast-enhanced and unenhanced scans in terms of shape and CT values. CONCLUSION The RE demonstrated characteristic CT features. The manifestations of nodular/patchy enhancement in the arterial phase, decreased density and shrinkage or disappearance during the venous phase, and no abnormality on unenhanced scans, as well as a close connection with the ICVP, may help differentiate RE from SM.
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Affiliation(s)
- Qiuxia Yang
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Jiahui Xu
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Jianyao Zhou
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Qiulin Liu
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zhijun Mai
- Department of Radiology, Cancer Hospital Chinese Academy of Medical Science, Shenzhen Center, Shenzhen, China
| | - Hui Xie
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Xiaohua Ban
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Lizhi Liu
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Rong Zhang
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
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Shin JI, Chee CG, Yoon MA, Chung HW, Lee MH, Lee SH. Vertebral Venous Congestion That May Mimic Vertebral Metastasis on Contrast-Enhanced Chest Computed Tomography in Chemoport Inserted Patients. Korean J Radiol 2024; 25:62-73. [PMID: 38184770 PMCID: PMC10788611 DOI: 10.3348/kjr.2023.0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/20/2023] [Accepted: 09/22/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence of vertebral venous congestion (VVC) in patients with chemoport insertion, evaluate the imaging characteristics of nodular VVC, and identify the factors associated with VVC. MATERIALS AND METHODS This retrospective single-center study was based on follow-up contrast-enhanced chest computed tomography (CT) of 1412 adult patients who underwent chemoport insertion between January 2016 and December 2016. The prevalence of venous stenosis, reflux, and VVC were evaluated. The imaging features of nodular VVC, including specific locations within the vertebral body, were analyzed. To identify the factors associated with VVC, patients with VVC were compared with a subset of patients without VVC who had been followed up for > 3 years without developing VVC after chemoport insertion. Toward this, a multivariable logistic regression analysis was performed. RESULTS After excluding 333 patients, 1079 were analyzed (mean age ± standard deviation, 62.3 ± 11.6 years; 540 females). The prevalence of VVC was 5.8% (63/1079), with all patients (63/63) demonstrating vertebral venous reflux and 67% (42/63) with innominate vein stenosis. The median interval between chemoport insertion and VVC was 515 days (interquartile range, 204-881 days). The prevalence of nodular VVC was 1.5% (16/1079), with a mean size of 5.9 ± 3.1 mm and attenuation of 784 ± 162 HU. Nodular VVC tended to be located subcortically. Forty-four patients with VVC underwent CT examinations with contrast injections in both arms; the VVC disappeared in 70% (31/44) when the contrast was injected in the arm contralateral to the chemoport site. Bevacizumab use was independently associated with VVC (odds ratio, 3.45; P < 0.001). CONCLUSION The prevalence of VVC and nodular VVC was low in patients who underwent chemoport insertion. Nodular VVC was always accompanied by vertebral venous reflux and tended to be located subcortically. To avoid VVC, contrast injection in the arm contralateral to the chemoport site is preferred.
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Affiliation(s)
- Jeong In Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choong Guen Chee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Min A Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Hee Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Hoon Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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McGuire AM, Chamberlin J, Baruah D, Munden RF, Kabakus IM. Virtual Noncontrast Reconstructions on Contrast-Enhanced Dual-Energy CT for the Differentiation of Vertebral Venous Congestion and Sclerotic Metastasis. AJR Am J Roentgenol 2024; 222:e2330152. [PMID: 37703196 DOI: 10.2214/ajr.23.30152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Aaron M McGuire
- Department of Radiology, Medical University of South Carolina, 25 Courtney Dr., Charleston, SC 29425
| | - Jordan Chamberlin
- Department of Radiology, Medical University of South Carolina, 25 Courtney Dr., Charleston, SC 29425
| | - Dhiraj Baruah
- Department of Radiology, Medical University of South Carolina, 25 Courtney Dr., Charleston, SC 29425
| | - Reginald F Munden
- Department of Radiology, Medical University of South Carolina, 25 Courtney Dr., Charleston, SC 29425
| | - Ismail M Kabakus
- Department of Radiology, Medical University of South Carolina, 25 Courtney Dr., Charleston, SC 29425
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Bae K, Moon JI, Jeon KN. Left-Side Contrast-Injection-Induced Pseudopathologic Vertebral Enhancement in Oncology Patients without Venous Obstruction: A Report of Two Cases. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:79. [PMID: 38256340 PMCID: PMC10821058 DOI: 10.3390/medicina60010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
The appearance of sclerotic bone lesions in contrast-enhanced computed tomography (CT) scans is often a significant concern for the possible presence of metastatic disease, especially in individuals with a known history of cancer. Prior research has demonstrated that in cases where patients suffer from thrombosis in major veins like the superior vena cava or the brachiocephalic vein, vertebral venous congestion can create imaging patterns on CT scans that resemble sclerotic bone metastases. However, instances of such imaging findings in patients without any form of venous obstruction are not commonly reported. In this study, we present cases of pseudopathologic vertebral enhancement observed consistently following left-side contrast injections in cancer patients devoid of venous obstruction. We aim to discuss and propose a potential mechanism for this phenomenon, drawing attention to a less commonly recognized diagnostic consideration in oncological imaging.
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Affiliation(s)
- Kyungsoo Bae
- Department of Radiology, Institute of Medical Science, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea; (K.B.); (J.I.M.)
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea
| | - Jin Il Moon
- Department of Radiology, Institute of Medical Science, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea; (K.B.); (J.I.M.)
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea
| | - Kyung Nyeo Jeon
- Department of Radiology, Institute of Medical Science, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea; (K.B.); (J.I.M.)
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea
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Pretet V, Moreau A, Larrouquere L, Mognetti T, Kryza D. A False-Positive Bone Oligometastatic Prostate Cancer in 18 F-Choline PET/CT : Be Aware of Chronic Vascular Pitfalls. Clin Nucl Med 2023; 48:1059-1061. [PMID: 37796178 DOI: 10.1097/rlu.0000000000004883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
ABSTRACT We report the case of a 71-year-old man undergoing initial assessment for a high-risk group prostate adenocarcinoma. His medical history includes gastric carcinoma treated with surgery and chemotherapy. 18 F-choline PET/CT was performed for initial staging and displayed several intense foci uptake of sternum and thoracic vertebrae, suggestive of bone metastasis. Because of a chronic right jugulosubclavian confluent thrombosis related to his implantable chamber, a control was performed 3 weeks later. It showed spontaneous disappearance of those uptakes, consistent with pitfalls related to the collateral circulation induced by the chronic right subclavian vein thrombosis, despite the chronic anticoagulation.
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Patiño P, Semionov A, Sayegh K, Kosiuk J, Pressacco J. Diagnostic pitfalls in computed tomography of the chest. Acta Radiol 2023; 64:533-541. [PMID: 35171051 DOI: 10.1177/02841851221080011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anatomical variants and imaging artifacts on thoracic computed tomography (CT), when unrecognized as such, can lead to radiological misinterpretation and erroneous diagnosis. This is a concise review of 15 common CT diagnostic pitfalls due to anatomical variants and imaging artifacts which have potential to be misinterpreted as significant pathology, such as neoplasia, infection, traumatic injury, interstitial lung disease, pleural disease, or vascular lesions.
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Affiliation(s)
- Paula Patiño
- Department of Diagnostic Radiology, 54473McGill University Health Centre, Montreal, QC, Canada
| | - Alexandre Semionov
- Department of Diagnostic Radiology, 5620McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | - Karl Sayegh
- Department of Diagnostic Radiology, 54473McGill University Health Centre, Montreal, QC, Canada
| | - John Kosiuk
- Department of Diagnostic Radiology, 54473McGill University Health Centre, Montreal, QC, Canada
| | - Josephine Pressacco
- Department of Diagnostic Radiology, 54473McGill University Health Centre, Montreal, QC, Canada
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7
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Pattamapaspong N, Peh WCG. Benign incidental do-not-touch bone lesions. Br J Radiol 2023; 96:20211334. [PMID: 35604667 PMCID: PMC9975527 DOI: 10.1259/bjr.20211334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023] Open
Abstract
Benign bone lesions may occasionally be incidentally detected on radiographs and are also increasingly found on CT or MRI performed for other clinical indications. Although mostly asymptomatic or associated with minor symptoms, these lesions may simulate true pathological lesions, causing problems in diagnosis. For instance, asymptomatic benign bone lesions can be misinterpreted as metastasis when incidentally encountered in a patient with known cancer. Recognising these entities as "do-not-touch" lesions helps avoid unnecessary further investigation or harmful intervention. In this review, we highlight three groups of bone incidentalomas found in adults, namely: osteolytic lesions, osteoblastic lesions, and bone protuberances. We aim to review the key imaging features of selected common and less common conditions in these three groups, so as to help radiologists confidently identify these benign do-not-touch lesions and to distinguish them from more sinister pathological lesions.
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Affiliation(s)
- Nuttaya Pattamapaspong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wilfred CG Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun Central, Singapore
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8
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Lasvergnas J, Playe M, Saint-Val L, Brillet PY, Soussan M, Duchemann B. Pitfalls in Cancer Evaluation in Case of Chronic Superior Vena Cava Obstruction: Vertebral Enhancement and Hot Quadrate Sign in the Liver. J Thorac Oncol 2021; 17:324-326. [PMID: 34843990 DOI: 10.1016/j.jtho.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Julie Lasvergnas
- Department of Medical and Thoracic Oncology, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Margot Playe
- Department of Nuclear Medicine, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Laura Saint-Val
- Department of Radiology, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Pierre-Yves Brillet
- Department of Radiology, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Michael Soussan
- Department of Nuclear Medicine, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Boris Duchemann
- Department of Medical and Thoracic Oncology, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France.
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9
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Fukamizu EMN, Seabra A, Otto DY, Sawamura MVY, Bordalo-Rodrigues M, Helito PVP. Vanishing bone metastasis: pictorial essay. Radiol Bras 2021; 54:336-340. [PMID: 34602670 PMCID: PMC8475168 DOI: 10.1590/0100-3984.2020.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022] Open
Abstract
Vanishing bone metastasis (pseudopathological vertebral body enhancement) is a pitfall in the interpretation of contrast-enhanced computed tomography (CT) scans of patients with thoracic vein obstruction, mainly in the superior vena cava and brachiocephalic veins, typically being related to thrombosis due to malignant tumors. On the basis of the CT findings, pseudopathological vertebral body enhancement can be misdiagnosed as sclerotic bone metastasis, leading to unnecessary treatment. Although not rare, pseudopathological vertebral body enhancement is usually underdiagnosed by radiologists. The aim of this study is to review the pathophysiology of this phenomenon, illustrating the most common collateral venous pathways in thoracic vein obstruction and making the correlation with the CT findings.
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Affiliation(s)
| | - Adriano Seabra
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Deborah Yukiko Otto
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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10
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Vanishing Bone Metastases in 18F-FDG PET/CT. Clin Nucl Med 2020; 45:559-560. [PMID: 32433164 DOI: 10.1097/rlu.0000000000003089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 36-year-old woman with a history of large B-cell lymphoma was referred for the exploration of sclerotic bone thoracic vertebral metastases discovered on a contrast-enhanced CT examination. F-FDG PET showed no pathological uptake in the affected vertebrae, as well as normal vertebral density on the coupled unenhanced CT. After review of the initial contrast-enhanced CT, a left brachiocephalic vein stenosis was noted, leading to a retrograde contrast filling of the accessory hemiazygos vein and the capillary spaces within the vertebrae, mimicking sclerotic metastases.
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11
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D'Abadie P, Ghaye B, Jamar F. Vertebral uptake of 99mTc-macroaggregated albumin during lung perfusion scanning. World J Nucl Med 2020; 19:271-272. [PMID: 33354184 PMCID: PMC7745876 DOI: 10.4103/wjnm.wjnm_44_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/23/2019] [Indexed: 11/08/2022] Open
Abstract
A 53-year-old female underwent a lung ventilation/perfusion scintigraphy (V/Q scan) in the workup of extensive thrombosis of the left subclavian and internal jugular veins. The perfusion lung scan visualized an atypical uptake in the thoracic vertebrae. A chest Computed Tomography (CT) scan demonstrated unusual tortuous and opacified thoracic superficial veins, collaterals of the lateral thoracic vein. Many venous collateral pathways can be developed in the case of superior vena cava syndrome. 99mTc-macroaggregated albumin particles may pass through the lateral thoracic vein and eventually through the vertebral venous plexus before being finally trapped by the vertebral capillaries. Besides right-to-left shunting, extrapulmonary uptake in the lung perfusion scintigraphy is very rare and may be used by collateral venous pathways.
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Affiliation(s)
- Philippe D'Abadie
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium
| | - Benoit Ghaye
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - François Jamar
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium
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12
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Dilated Internal Thoracic Vertebral Venous Plexus Simulating Bone Metastases on FDG PET/CT. Clin Nucl Med 2017; 43:e39-e42. [PMID: 29215407 DOI: 10.1097/rlu.0000000000001914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 42-year-old woman with a newly diagnosed malignant thymoma underwent FDG PET/CT, which demonstrated an increased uptake in anterior mediastinal tumor and several pleural masses in the right hemithorax, compatible with "drop metastases." In addition, contrast-enhanced CT images showed hyperdense abnormality in T2 vertebral body, congruent with intensely increased FDG uptake, raising suspicion of skeletal metastasis. This is a rare but important potential pitfall either in CT and FDG PET/CT-a "false-positive" bony lesion not attributed to skeletal metastasis but to dilated internal thoracic vertebral venous plexus associated with collateral circulation due to superior vena cava syndrome.
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13
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Realce vertebral secundario a congestión venosa en paciente con trombosis de la vena innominada: una causa de falsas metástasis óseas escleróticas. Arch Bronconeumol 2017; 53:462-463. [DOI: 10.1016/j.arbres.2016.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/13/2016] [Accepted: 12/26/2016] [Indexed: 11/19/2022]
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Arrivé L, Monnier-Cholley L, Maury E. Reply to “Vertebral Venous Congestion Mimicking Sclerotic Metastasis in the Absence of Venous Obstruction”. AJR Am J Roentgenol 2017; 208:W159-W159. [DOI: 10.2214/ajr.16.17564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Lionel Arrivé
- Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris Sorbonne Universités, UPMC Université Paris, Paris, France
| | - Laurence Monnier-Cholley
- Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris Sorbonne Universités, UPMC Université Paris, Paris, France
| | - Eric Maury
- Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris Sorbonne Universités, UPMC Université Paris, Paris, France
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Vertebral Venous Congestion Mimicking Sclerotic Metastasis in the Absence of Venous Obstruction. AJR Am J Roentgenol 2017; 208:W157-W158. [DOI: 10.2214/ajr.16.17473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Osteoblastic Metastases Mimickers on Contrast Enhanced CT. Case Rep Radiol 2017; 2017:7278016. [PMID: 28815098 PMCID: PMC5549491 DOI: 10.1155/2017/7278016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/14/2017] [Indexed: 11/17/2022] Open
Abstract
Secondary osseous involvement in lymphoma is more common compared to primary bone lymphoma. The finding of osseous lesion can be incidentally discovered during the course of the disease. However, osseous metastases are infrequently silent. Detection of osseous metastases is crucial for accurate staging and optimal treatment planning of lymphoma. The aim of imaging is to identify the presence and extent of osseous disease and to assess for possible complications such as pathological fracture of the load-bearing bones and cord compression if the lesion is spinal. We are presenting two patients with treated lymphoma who were in complete remission. On routine follow-up contrast enhanced CT, there were new osteoblastic lesions in the spine worrisome for metastases. Additional studies were performed for further evaluation of both of them which did not demonstrate any corresponding suspicious osseous lesion. The patients have a prior history of chronic venous occlusive thrombosis that resulted in collaterals formation. Contrast enhancement of the vertebral body marrow secondary to collaterals formation and venous flow through the vertebral venous plexus can mimic the appearance of spinal osteoblastic metastases.
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