Inferior vena cava pseudothrombosis

Case contributed by Ayush Goel
Diagnosis certain

Presentation

Vague abdominal pain. Previous ultrasound (1 day back) showed para-aortic nodes with mildly dilated IVC.

Patient Data

Age: 65
Gender: Male

The images show non-enhanced IVC below the level of renal veins. The enhancing renal veins enter the IVC and sections above this level show filling defects.

Case Discussion

Features consistent of IVC pseudothrombosis.

Inferior vena caval thrombosis mimics include :

  • pseudothrombosis :  caused by laminar flow of enhanced blood from renal veins streaming parallel to column of unopacified blood returning from lower body. Delayed images will show resolution of filling defect.
  • pseudolipoma (paracaval lipoma) is the partial volume artefact due to pericaval fat above caudate lobe, seen commonly in patients with chronic liver disease. Coronal reformats usually clear the doubt.

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