# Focal Hepatic Hot Spot (‘Hot Quadrate’) Sign on Contrast‑enhanced Abdominal CT: A Telltale Pearl Indicating Superior Vena Cava (SVC) Syndrome

## TL;DR

A specific liver enhancement pattern on CT scans can indicate superior vena cava syndrome.

## Contribution

A new, specific CT sign is identified for diagnosing superior vena cava syndrome.

## Key findings

- A focal hepatic hot spot in liver segment 4 is linked to SVC syndrome.
- Early vein filling of Sappey's veins is a key indicator in CT scans.
- This sign is pathognomonic for SVC syndrome.

## Abstract

Teaching point: Transient, topographically delineated, intense arterial enhancement in liver segment 4, associated with early filling of the dilated veins of Sappey, is a pathognomonic abdominal CT sign of superior vena cava (SVC) syndrome.