Application of spatio-temporal image correlation combined with high-difinition flow in demonstration of fetal azygos vein during the second gestation
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Objective To evaluate the feasibility of demonstrating the fetal azygos vein by spatio-temporal image correlation(STIC) combined with high-difinition flow(HD) imaging during the second gestation. Methods Two hundred fetuses between March 2013 to November 2013 were divided into 2 groups. In study group, STIC and HD were applied to demonstrate the azygos vein on the fetal thoracoabdominal para-midsagittal view, the relationship between the azygos vein and thoracic aorta, the shape, location and modality of archof azygos vein which joins the superior vena cava were observed after post processing.And two-dimensional ultrasound and color Doppler flow imaging(CDFI) was applyed in the control droup. Results 96/100 of the azygos vein was successfully demonstrated in the study group with the rate of 96%,while 85/100 was successfully demonstrated in the control group with the rate of 85%. According to the relationship of the azygos vein with the spine,the proportion of the right type,middle type and left type of the azygos vein was 26.0%,33.9%,40.1%. The azygos vein parallels with the thoracic aorta upside to the level of superior vena cava,and bends forward and joins the superior vena cava. In one case with hepatic segment of inferior vena cava interruption, wthe azygos vein was dilated with similar diameter to the thoracic aorta. Conclusion It is feasible to demonstrate the azygos vein by STIC combined with HD. The diameter, shape, location and manner of azygos vein can be observed.It can hint the diagnosis of disease that results in expansion of azygos vein. It is better than two-dimensional ultrasound combined.Keywords:
Azygos vein
Thoracic aorta
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Summary Variations seen in the thoracic vein system are related to the development of these veins. During the dissection from the posterior mediastinum of the 60-year-old male cadaver, it was observed that there was no complete accessory hemiazygos vein, and both posterior intercostal veins and hemiazygos vein (above T10 level) drained bilaterally to the azygos vein. Considering these types of variations is important during imaging this region and surgical operations.
Azygos vein
Abnormality
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Azygos vein
Lobe
Gross anatomy
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PURPOSE: To evaluate the prevalence and appearance of azygos arch valves at intravenous contrast material–enhanced computed tomography (CT). MATERIALS AND METHODS: Findings of 309 intravenous contrast-enhanced spiral CT examinations of the chest were retrospectively reviewed. The presence of contrast material reflux into the azygos arch and of a focal bulge in the azygos arch was recorded. An azygos valve was considered present if contrast material with a curvilinear posterior contour was seen in the azygos arch. The χ2 test was used to compare the frequency of contrast material reflux into the azygos vein for high and low rates of contrast material injection and for right and left arm injection. RESULTS: Reflux of contrast material into the azygos arch occurred at 154 (49.8%) of 309 examinations, and valves were seen on images of 105 (68.2%) examinations. A focal bulge was seen in the azygos arch on images of 86 (81.9%) of 105 examinations with an azygos valve. Contrast material refluxed more frequently into the azygos vein in examinations with high rates of injection (83 of 128 examinations, 64.8%) than in those with low rates of injection (71 of 181, 39.2%, P <.001). Among the patients with high rates of injection, contrast material refluxed more frequently into the azygos vein with the right arm injection than with left arm injection (53 of 70, 76% vs 30 of 58, 52%, P < .01). Refluxed contrast material appeared as discrete collections within cusps of the azygos valves on images of 69 (44.8%) of 154 examinations. CONCLUSION: Valves in the azygos arch are common and more frequently seen at CT when high injection rates and right arm injections are used. © RSNA, 2003
Azygos vein
Iodinated contrast
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Objective To investigate the relationship between intravenous hypertension myelopathy syndrome and the abnormality of the spinal veins. Methods The study was performed in 30 adults cadavers. The distributions, origins and valves of the lumbar veins, ascending lumbar veins and azygos veins were observed. The diameters of the above-mentioned veins were measured. Results The lumbar veins, where no valves were observed, were variable. Azygos vein originated from the right ascending lumbar vein and was drained into superior vena cava. Hemiazygos vein originated from left ascending lumbar vein, and collected the blood of left posterior intercostal veins and accessory hemiazygos vein. The lower segment of azygos vein and hemiazygos vein were drained into vena iliac communis and inferior vena cava. Conclusions The lumbar vein, ascending lumbar vein and azygos vein drain the venous blood of the thoracolumbar segment of the spinal cord. The narrow of them can produce the spinal veins congestion and the intravenous hyperten-sion in the vertebral tube.
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Objective: To Provide morphologic basis and operation designs for spinal cord protection during aortic operation. Methods: The human azygos venous system, vertebral venous plexus, and the venous drainage of spinal cord in 31 human adult cadaveric specimens were investigated by means of routine dissection. Results: The azygos venous system and related veins were observed.The diameters were as follows: azygos vein 9.2±1.9 mm, hemiazygos vein 5.5±1.2 mm, accessory hemiazygos vein 3.8±0.9 mm, left superior intercostals vein 2.0±0.4 mm, right superior intercostals vein 1.9±0.4 mm, left ascending lumbar vein 2.3±0.5 mm, right ascending lumbar vein 2.2±0.6 mm.According to the distribution patterns of the tributaries of azygos vein and the forms of intercostals venous opening, the azygos venous system might be divided into 4 types.The venous valves with variable forms and dimensions were found in the tributaries of the azygos vein.The distribution ensity of spinal veins were rich, the vascular anastomoses between spinal veins and internal vertebral venous plexus were abundant.By way of spinal radicular veins, they communicated with external vertebral venous plexus and azygos venous system. Conclusion: It is a new and feasible method to retrograde perfusion of the azygos vein for spinal cord protection during aortic operation.
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Venous plexus
Cadaveric spasm
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Lobe
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The azygos lobe of the lung is a normal variant in 1% of anatomic specimens and 0.4% of chest radiographs. The right posterior cardinal vein, precursor of the azygos vein, invaginates the lung carrying pleural layers (azygos fissure) entrapping a portion of the right upper lobe. In thoracic outlet syndrome costoclavicular compression alters fascial planes, compressing the bicuspid valves in the draining veins of the supraclavicular fossa, neck and mediastinum, impeding venous return to the right heart and dilating veins proximal to the compression. The azygos vein dilates, particularly in compression of the brachiocephalic vein, providing collateral circulation from the abdomen, pelvis and thorax. Bilateral MRI/MRA/MRV displays the sites of costoclavicular compression of bicuspid valves within lymphatics, draining veins of the neck and supraclavicular fossae and the subclavian and axillary arteries with binding nerve roots (JNMA 1999; 91:333–341). Monitored multiplanar images with abduction external rotation and 2D Time of Flight MRA/MRV without contrast were acquired on a 1.5 Tesla GE Signa LX unit, 44 cm field of view, 512 × 256 matrix and saline water bags to enhance signal to noise ratio. We present two TOS patients with costoclavicular compression and impedance to venous return. One patient has an azygos lobe, the other a right aortic arch with anomalous course of the azygos vein.
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Subclavian vein
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Abstract A case of double superior venae cavae with bilaterally symmetrical azygos veins is recorded for a 45 year old Caucasian male cadaver with no history of cardiovascular disorder. Death was reported as resulting from carcinoma of abominal viscera with extensive metastases. A review of the literature since 1887 indicates that this is an addition to 216 cases of double superior venae cavae and seven cases of double azygos veins previously reported in cadavers. A typical left brachiocephalic vein was absent. The anomalous vena cava, formed by union of left internal jugular and left subclavian veins behind the sternoclavicular joint, coursed vertically through the superior mediastinum, continued through the atrioventricular sulcus and opened into the right atrium near the orifice of the inferior vena cava. It was almost completely symmetrical with the right and received a complete azygos vein. The anomaly is explained as (a) failure of the precardinal anastomosis to form, (2) persistence of the entire left anterior and common cardinal veins and left horn of the sinus venosus, and (3) persistence of the proximal part of the left posterior cardinal which with the left supracardinal forms the left azygos vein. Morphological and clinical significances of the anomaly are discussed.
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Azygos vein
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The posterior thoracic wall, an area drained by the azygos venous system, is
a common site for surgical intervention. Since the venous part of the cardiovascular
system is subject to most common variation, abnormalities in the azygos
venous system are often reported. Some of the anatomical variants have significant
clinical implications for computed tomography image assessment and
mediastinal surgery.
During dissection of the posterior mediastinum in a 76 year-old Caucasian male
cadaver we found a rare variation in the azygos venous system. The hemiazygos
vein drained the left 9th to 11th left posterior intercostal veins. While passing ventrally
to the aorta at the level of the body of the eighth thoracic vertebra it was
joined by two separate vessels found to be the continuations of the 7th and 8th left
posterior intercostal veins. The resultant dilated vessel, termed the interazygos
vein, then opened into the azygos vein on the right side of the vertebral column.
Variation in the azygos venous system has often been reported, but the abnormality
observed by us appears to be extremely rare. The interazygos vein passing
ventrally to the aorta may mimic enlarged lymph nodes and cause misinterpretation
of a computed tomography image or, if accidentally damaged during mediastinal
surgery, may lead to intraoperative haemorrhage. To the best of our knowledge
this report provides new data of potential clinical significance.
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