THE USEFULNESS OF THE ULTRASOUND EXAMINATION IN DIAGNOSTICS OF INFERIOR VENA CAVA (IVC) PATHOLOGIES.

Ultrasound (US) assessment is a useful modality for initial evaluation when a pathologic condition of the inferior vena cava (IVC) is suspected. This pictorial essay aimed to assess the diagnostics efficacy of US examination of IVC pathologies. A group of 21 adult patients (8 females) was referred to an US evaluation of the IVC. Patients presented symptoms such as leg swelling, and abdominal pain. All patients fasted prior to the study. If the IVC was obscured, the examination was repeated 1-2 days after adequate preparation. Each US examination was performed using the Logiq 7 GE Medical System with a convex probe at 3,5 MHz using B-presentation, Doppler, and B-flow options. The tests were performed with the patient supine. In the 66,7% of patients the first examination allowed for unequivocal assessment of IVC. Three patients were diagnosed with unilateral renal vein tumor thrombus extending to the IVC. In six other patients, non-neoplastic thrombi were found. In four of them, the thrombus involved iliac veins. In two patients the thrombus involved both the iliac veins and the IVC. In one patient intravenous leiomyomatosis was reported in the IVC. The rest of the patients did not have any pathology visible on US. Three of the patients diagnosed with thrombosis were qualified for IVC filter placement. Two patients were qualified due to iliocaval thrombus and one due to progression of thrombus during anticoagulation. US examination enables the evaluation the entire course of IVC and the diagnosis of IVC pathology, including neoplasms, thrombosis, and leiomyomatosis. Additionally, it allows for assessment of blood flow with color Doppler, and differentiation of the thrombus character - neoplastic vs non-neoplastic with the use of contrast-enhanced ultrasonography. Moreover, the IVC US evaluation allows for the identification of indications for the implantation of the IVC filter. [ABSTRACT FROM AUTHOR]