Subclavian vein thrombosis detected with spiral CT and three-dimensional reconstruction.

Volumetric CT [1], or spiral CT, has been successfully used to examine thoracic blood vessels such as the pulmonary arteries for emboli [2], to image the heart after bypass graft surgery [3], and to assess for aortic vascular disease [4]. The use of spiral CT to examine venous structures in the thorax and upper limbs has not, to our knowledge, been previously described. Full assessment for potential thrombus in the superior vena cava or a major tributary in a patient in whom malignant tumors are of primary concern would normally require not only contrast-enhanced thoracic CT but bilateral upper extremity phlebography. Such an approach would entail the use of large amounts of iodinated contrast media and multipIe departmental resources. We report a case in which we used spiral CT with three-dimensional reconstruction to generate phlebographic images of subclavian vein thrombosis.