CTICasesRight Atrial Pseudo-Thrombus from IVC Inflow
Imaging findings
Gated cardiac CT shows a low-attenuation, mass-like filling defect in the right atrium near the IVC inflow, which completely fills with contrast on delayed phase imaging.
Key takeaways
Transient interruption of contrast or unopacified blood entering the right atrium from the IVC (smoke/stasis phenomenon) can create a filling defect that mimics a right atrial thrombus or tumor (pseudo-thrombus). A delayed phase scan is diagnostic by showing complete contrast mixing.
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