Review Article

Imaging of inferior vena cava normal variants, anomalies and pathologies, Part 2: Acquired

Ranjit K. Chaudhary, Pankaj Nepal, Shruti Kumar, Elina Gupta, Nikita Sangroula, Arpit Nagar, Vijayanadh Ojili
South African Journal of Radiology | Vol 27, No 1 | a2694 | DOI: https://doi.org/10.4102/sajr.v27i1.2694 | © 2023 Ranjit K. Chaudhary, Pankaj Nepal, Shruti Kumar, Elina Gupta, Nikita Sangroula, Arpit Nagar, Vijayanadh Ojili | This work is licensed under CC Attribution 4.0
Submitted: 08 April 2023 | Published: 08 December 2023

About the author(s)

Ranjit K. Chaudhary, Department of Radiology, St. Vincent’s Medical Center, Bridgeport, United States
Pankaj Nepal, Department of Radiology, Massachusetts General Hospital, Boston, United States
Shruti Kumar, Department of Radiology, University of Arkansas, Little Rock, United States
Elina Gupta, Department of Radiology, St. Vincent’s Medical Center, Bridgeport, United States
Nikita Sangroula, Department of Radiology, St. Vincent’s Medical Center, Bridgeport, United States
Arpit Nagar, Department of Radiology, Ohio State University Wexner Medical Center, Columbus, United States
Vijayanadh Ojili, Department of Radiology, University of Texas Health, San Antonio, United States

Abstract

The inferior vena cava (IVC) is an uncommon site for primary pathologies and secondary involvement is also infrequent, but involvement of the IVC can often drastically change management. It is therefore important to be cognizant of IVC pathologies. This review discussed common and rare neoplastic and non-neoplastic pathologies of the IVC as well as pathology mimics. Primary and secondary neoplasms can lead to tumour extension or bland thrombus formation and it is often important to distinguish between these two entities. It is also important to be aware of pseudo-lesions for accurate diagnosis. Inferior vena cava filter placement and endovascular treatment of the aorta are commonly performed procedures that can be associated with devastating complications, which are luckily infrequent. The calibre of the IVC also has its own clinical significance. Inferior vena cava pathologies, although rare, have a dramatic impact on the patient’s outcome and knowledge of these pathologies is prudent.

Contribution: Understand the principles of IVC imaging, the common as well as the rare primary and secondary IVC tumours, differentiate between tumour thrombus and bland thrombus, and recognise IVC lesion mimics and life-threatening pathologies involving the IVC.


Keywords

IVC; vena cava; IVC neoplasms; tumour thrombus; IVC perforation; megacava; slit-like IVC; Budd-Chiari Syndrome; fistula; pseudolesion.

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