Emergency computed tomography in the diagnosis of superior vena cava syndrome

Jeffrey A. Miller*, Sunita Singh-Panghaal, Marc Simmons, Charles Levine, Pierre Maldjian, Stephen Baker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Superior vena cava syndrome (SVCS) presents with a number of nonspecific symptoms that must be assessed rapidly to prevent life-threatening sequelae such as cerebral edema and respiratory failure. To define the utility of computed tomography (CT) in evaluating SVCS, we initiated a retrospective analysis of all emergent chest CT scans performed at our affiliated institutions to rule out SVCS. Twenty-eight emergent chest CT scans were analyzed. In all 23 cases confirmed to have SVCS (true-positives), CT depicted the nature and extent of the obstructing lesions. In 4 of 5 symptomatic cases (80%) proven not to have SVCS, CT imaged the abnormalities responsible for the misleading clinical appearance. CT also outlined the extent and course of superficial chest wall venous collaterals in all 23 true-positive cases and that of mediastinal collaterals in 18 cases. We also found 12 patients to have CT evidence of soft tissue edema of the upper thorax, an indicator of SVCS not previously detailed. A large number of related, unsuspected lesions were also identified. Our study supports the emergent use of chest CT as the imaging modality of choice in the work-up of patients presenting with the clinical suspicion of SVCS.

Original languageEnglish
Pages (from-to)267-272
Number of pages6
JournalEmergency Radiology
Issue number5
StatePublished - Sep 1995
Externally publishedYes


  • Azygos vein
  • Computed tomography
  • Hemiazygos vein
  • Superior vena cava syndrome
  • Venous collaterals


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