# Left-Side Contrast-Injection-Induced Pseudopathologic Vertebral Enhancement in Oncology Patients without Venous Obstruction: A Report of Two Cases

## TL;DR

This paper reports two cases where contrast injections caused misleading imaging results in cancer patients, mimicking bone metastases without actual venous blockage.

## Contribution

The study highlights a rare imaging phenomenon caused by left-side contrast injection in oncology patients without venous obstruction.

## Key findings

- Pseudopathologic vertebral enhancement was observed in two cancer patients after left-side contrast injection.
- The enhancement mimicked sclerotic bone metastases but occurred without venous obstruction.
- A potential mechanism for this imaging artifact is proposed.

## Abstract

The appearance of sclerotic bone lesions in contrast-enhanced computed tomography (CT) scans is often a significant concern for the possible presence of metastatic disease, especially in individuals with a known history of cancer. Prior research has demonstrated that in cases where patients suffer from thrombosis in major veins like the superior vena cava or the brachiocephalic vein, vertebral venous congestion can create imaging patterns on CT scans that resemble sclerotic bone metastases. However, instances of such imaging findings in patients without any form of venous obstruction are not commonly reported. In this study, we present cases of pseudopathologic vertebral enhancement observed consistently following left-side contrast injections in cancer patients devoid of venous obstruction. We aim to discuss and propose a potential mechanism for this phenomenon, drawing attention to a less commonly recognized diagnostic consideration in oncological imaging.