SVC Syndrome: Can We Predict SVC Syndrome on CT?

OBJECTIVE: To systematically investigate imaging findings of superior vena cava syndrome(SVCS) on CT to predict SVCS in malignancy patients.？SUBJECTS AND METHODS: From Janunary 2010 to August 2011, chest CTs with narrowing or obstruction of superior vena cava(SVC) were searched from hospital imaging database. After that patients were classified into two groups; SVCS group and non-SVCS group, based on clinical manifestation of SVCS. The long diameter of tumor, presence or absence of intratumoral nerosis, short diameter of SVC, presence or absence of architecture distortion of SVC, subcutaneous edema, and collateral vessels were evaluated.Differences between SVCS group and non-SVCS group were analyzed using the Wilconcox test and x2 test (p<0.05).RESULTS: A total of 29 patient were included in this study. Among them, 11 patients were SVCS group, and 18 patients were non-SVCS group. The mean diameter of main mass was 8.2cm and 5.5cm in SVCS group and non-SVCS, respectively (p=0.04). The presence of collateral vessels was significantly frequent in non-SVCS group (n=4 of 18, 22%) than SVCS group (n= 1of 11, 9%) ？(p<0.01). The prevalence of chest wall edema was much frequent in SVCS group, but there was no statistically significant difference (p=0.09). The central necrosis of the main mass were found in 5 of 11 in SVCS group (45%), and in 8 of 18(44%) in non-SVCS group (p=0.72). There was no statistical significant difference in SVC diameter or architecture distortion between two groups.？CONCLUSION: Knowledge of the predictive imaging findings of SVSC in malignant patients leads to more proper management of patients