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Radionuclide Venography and Its Functional Analysis in Superior Vena Cava Syndrome

Department of Respiratory Medicine, Institute of Development, Aging and Cancer (formerly Research Institute for Chest Diseases and Cancer), Tohoku University, Sendai, Japan

Correspondence: For correspondence or reprints contact: Asif Mujtaba Mahmud, Department of Respiratory Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryoumachi, Aoba-ku, Sendai 980, Japan.

ABSTRACT

In addition to imaging, radionuclide venography maybe used for the functional assessment of superior vena cava (SVC) syndrome by applying the indices of transit time (TT), time of half-peak count (TH) and peak count ratio (PC ratio). Methods: Ten healthy subjects (Group N) and 107 patients with SVC syndrome (64 symptomatic and 43 asymptomatic) were studied. Images were visually assessed for collaterals or jugular venous reflux and values of the indices were calculated. Results: The 107 patients were subclassified into three groups according to the images obtained. Collateral circulation was seen in 37 patients (Group C). In 20 patients, jugular venous reflux was observed (Group J). Fifty patients who showed neither collaterals nor reflux were included in Group P. In comparison to Group N [3.6 ± 0.56 sec (sem)],TT values were significantly higher (p < 0.05) for Group J (7.13 ± 1.16 sec) and Group C (7.00 ± 0.87 sec). Values of TH were significantly prolonged (p < 0.05) for Group J (23.6 ± 4.8 sec) and Group C (18.8 ± 2.2 sec) in comparison to Group N (9.2 ± 1.5 sec). PC ratio values were higher in all patient groups in comparison to Group N (3.4 ± 0.57). Conclusion: These indices are potentially useful in the initial diagnosis and post-therapeutic evaluation of SVC syndrome. In the absence of other causes, appearance of jugular venous reflux may be considered a sign of SVC syndrome.

Key Words: radionuclide venography • superior vena cava syndrome • jugular venous reflux • functional indices