Computed tomography features of acute thrombosis of central veins with perivenous inflammatory changes

Objective: Our purpose was to examine the computed tomographic findings in 13 patients with acute deep venous thrombosis (DVT) of central veins of the neck, chest, and abdomen in whom major perivenous inflammatory changes were noted. Methods: During a 10-year period, 13 patients with acute DVT of 21 central veins and marked perivenous inflammatory changes on computed tomography were identified. Computed tomography images were assessed for location of DVT and pattern of perivenous changes. Results: The perivenous changes took the form of a rounded or lobulated perivenous bulky mass (massive pattern or tumorlike) in 5 patients and of infiltrative changes in the other 8 patients. Direct visualization of the thrombotic vein was possible in 8 patients. Follow-up examinations (range, 6-36 months; mean, 15 months) demonstrated resolution of perivenous inflammatory changes with anticoagulation therapy in all cases. Conclusion: Perivenous inflammatory changes around the thrombotic vein presented as a rounded or lobulated perivenous bulky mass that may mimic a tumor or as infiltrative perivenous changes.