Thoracic Complications in Behçet’s Disease: Imaging Findings

Figure 6

A 30-year-old male who presented with a history symptoms and signs of SVC syndrome for five years. He presented with a marked respiratory distress with cough and dyspnea. (a) Upper extremity contrast-enhanced venography shows bilateral occlusion of brachiocephalic veins and SVC. Also note the collateral veins in the chest wall and axillary region. (b) Follow-up axial contrast-enhanced chest CT scan shows nonopacification of the SVC (short arrow) and opacification of the multiple mediastinal veins (arrows). (c) Coronal maximum-intensity projection (MIP) reformation shows occlusion of the SVC due to thrombosis (long arrow) and bilaterally complete occlusion of the brachiocephalic, subclavian, and axillary veins. (d) Also, sagittal reformatted CT scan reveals that venous drainage from thorax is via the azygos system (arrow head) to SVC (arrow). (e) Coronal MIP reformation shows collateral flow through dilated pericardial vein (arrow head). (f) Coronal maximum-intensity (MIP) projection image from gadolinium-enhanced 3D MR angiography shows occlusion of the thoracic veins and SVC and dilated azygos vein (AV) and collateral veins at thoracic inlet level and chest wall (arrow heads) on the right (IVC: arrowhead). Behçet’s disease was clinically diagnosed because of recurrent oral and genital ulcerations and positive pathergy test. The diagnosis was confirmed by histopathologic examination.

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