Focal hepatic hot spot sign (SVC obstruction)

Case contributed by Sachi Hapugoda


Suspected pulmonary embolism with chest pain and dyspnea. History of long term central catheterization for haemodialysis and venous stents.

Patient Data

Age: 35 years

No pulmonary embolism. Stenting spans the left jugular brachiocephalic vein and SVC which are all occluded. Features of collateralisation with contrast in the intercostal and azygos venous system, and in the IVC and its tributaries. Incidental parafalciform enhancement demonstrated in the liver (focal hot spot sign) consistent with the known SVC obstruction.

Case Discussion

Demonstration of a focal hepatic hot spot sign due to SVC obstruction in the setting of previous long term central catheterization for haemodialysis.

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