若林 透, 山田 博美, 田中 正雄, 河野 純, 八木 ひかる, 三澤 卓夫, 本郷 実, 大久保 信一, 関口 守衛

Toru WAKABAYASHI, Hiroyoshi YAMADA, Masao TANAKA, Jun KONO, Hikaru YAGI, Takuo MISAWA, Minoru HONGO, Shinichi OKUBO, Morie SEKIGUCHI

信州大学医学部第一内科

The First Department of Internal Medicine, Shinshu University School of Medicine

キーワード : Superior vena cava syndrome, Superior vena cava flow velocity, Pulsed Doppler echocardiography

The superior vena cava (SVC) flow was recorded by pulsed Doppler echocardiography before and after treatment in three patients with SVC syndrome. One patient with a mediastinal tumor (case 1) was treated with chemotherapy. Two patients with lung cancer (case 2, case 3) were treated with radiotherapy.
In normal control subjects, we observed normal SVC flow patterns (small positive A, large negative S, small positive R, and large negative D wave) and normal SVC peak flow velocities (44.0±8.4 cm/sec).
Before treatment, the normal SVC flow pattern was absent and the peak flow velocity was decreased in each of the 3 cases (peak velocity was 26.6 cm/sec in case 1, 15.8 cm/sec in case 2, and 25.0 cm/sec in case 3). Following treatment and improved clinical signs, SVC peak flow velocities were increased in all patients (case 1: 33.0 cm/sec, case 2: 27.7 cm/sec, and case 3: 37.2 cm/sec). However, the SVC flow pattern was normalized in only one patient (case 1).
These findings suggest the usefulness of pulsed Doppler echocardiography in evaluating the effectiveness of treatments for SVC syndrome.