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Erschienen in: Surgical and Radiologic Anatomy 3/2021

03.10.2020 | Original Article

Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact

verfasst von: Konstantinos Koutsouflianiotis, Georgios Daniil, Georgios Paraskevas, Maria Piagkou, Chrysanthos Chrysanthou, Konstantinos Natsis

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 3/2021

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Abstract

Purpose

The study highlights azygos vein (AV) topography, arrangement and confluence morphometry in dyspnoea and tachycardia patients of extrapulmonary and extracardiac aetiology.

Method

Computed-tomography angiography of 25 male and 26 female patients (mean age 66.5 years) were studied for: thoracic vertebral (T) height of AV- superior vena cava-SVC confluence, AV course and deviations from vertebral column (VC) midline, AV and SVC diameters, distance (AV arch- lower border of carina) and gender and age impact.

Results

Commonest heights of the AV-SVC confluence were T5 (56.9%), T4 (31.4%), T6 (9.8%) and T3 (2%). The AV terminated into SVC after crossing the left side of VC midline in 56.9%, slightly deviated right of the midline in 37.3% and coursed right of VC in 5.9%. Mean AV and SVC diameters were 0.96 ± 0.18 cm and 1.86 ± 0.27 cm. Male predominance in AV and SVC diameters and a slight AV diameter significant increase with the age were found. The (AV highest point—lower border of carina) mean distance was 2.05 ± 0.44 cm and male predominance existed.

Conclusion

The commonest termination height of the AV was T5, while T3 was the rarest one. Aging induces the AV leftward displacement, while gender had no impact. AV and SVC diameters had higher significant values in males, while ageing had a significant impact only in AV diameter. The AV higher diameters will be used as predictors for higher values of SVC diameter and mediastinum pathology. Such findings can be useful in mediastinal surgery, mediastinoscopy and surgery of VC deformations, neurovascular surgery of retroperitoneal organs, disc herniation and T fractures.
Literatur
1.
Zurück zum Zitat Anson MV (1984) Surgical anatomy, 6th edn. Saunders Company, Chicago Anson MV (1984) Surgical anatomy, 6th edn. Saunders Company, Chicago
2.
Zurück zum Zitat Arey LB (1954) Developmental Anatomy, 6th ed. Philadelphia: W.B. Saunders Company; 1954. Arey LB (1954) Developmental Anatomy, 6th ed. Philadelphia: W.B. Saunders Company; 1954.
3.
Zurück zum Zitat Bales G (2014) A semi-quantitative approach to variation of the azygos vein course. Clin Anat 27:1030–1037CrossRef Bales G (2014) A semi-quantitative approach to variation of the azygos vein course. Clin Anat 27:1030–1037CrossRef
5.
Zurück zum Zitat Bergman RA, Thompson SA, Afifi AK. 1988. Compendium of Human Anatomic Variation. Text, Atlas, and World Literature. Baltimore: Urban & Schwarzenberg. 593 p. Bergman RA, Thompson SA, Afifi AK. 1988. Compendium of Human Anatomic Variation. Text, Atlas, and World Literature. Baltimore: Urban & Schwarzenberg. 593 p.
6.
Zurück zum Zitat Celik HH, Sargon MF, Aldur MM, Cumhur M (1996) An anomalous course of the interazygos vein. Surg Radiol Anat 18(1):61–62CrossRef Celik HH, Sargon MF, Aldur MM, Cumhur M (1996) An anomalous course of the interazygos vein. Surg Radiol Anat 18(1):61–62CrossRef
7.
Zurück zum Zitat Crummy AB, Wegner GP, Flaherty TT, Benfield JR, Brunette KW, Francyk WP (1968) Azygos venography: an aid in the evaluation of esophageal carcinoma. Ann Thorac Surg 6(6):522–527CrossRef Crummy AB, Wegner GP, Flaherty TT, Benfield JR, Brunette KW, Francyk WP (1968) Azygos venography: an aid in the evaluation of esophageal carcinoma. Ann Thorac Surg 6(6):522–527CrossRef
8.
Zurück zum Zitat Dahran N, Soames R (2016) Anatomical variations of the azygos venous system: classification and clinical relevance. Int J Morphol 4(3):1128–1136CrossRef Dahran N, Soames R (2016) Anatomical variations of the azygos venous system: classification and clinical relevance. Int J Morphol 4(3):1128–1136CrossRef
9.
Zurück zum Zitat Dudiak CM, Olson MC, Posniak HV (1991) CT evaluation of congenital and acquired abnormalities of the azygos system. Radiographics 11:233–246CrossRef Dudiak CM, Olson MC, Posniak HV (1991) CT evaluation of congenital and acquired abnormalities of the azygos system. Radiographics 11:233–246CrossRef
10.
Zurück zum Zitat Fleischner FG, Udis SW (1952) Dilatation of the azygos vein: a roentgen sign of venous engorgement. Am J Roentgenol 67:569–575 Fleischner FG, Udis SW (1952) Dilatation of the azygos vein: a roentgen sign of venous engorgement. Am J Roentgenol 67:569–575
11.
Zurück zum Zitat Fukutome M (1951) Vv. thoracica longitudinales observed in Japanese in Kyushu. Kumamoto Daigaku Igakubu Daini Kaibougaku Kyoshitsu Ronbun Shu 2:71–84 (in Japanese) Fukutome M (1951) Vv. thoracica longitudinales observed in Japanese in Kyushu. Kumamoto Daigaku Igakubu Daini Kaibougaku Kyoshitsu Ronbun Shu 2:71–84 (in Japanese)
12.
Zurück zum Zitat Ghuysen A, Ghaye B, Willems V, Lambermont B, Gerard P, Dondelinger R, D’Orio V (2005) Computed tomographic pulmonary angiography and prognostic significance in patients with acute pulmonary embolism. Thorax 60:956–961CrossRef Ghuysen A, Ghaye B, Willems V, Lambermont B, Gerard P, Dondelinger R, D’Orio V (2005) Computed tomographic pulmonary angiography and prognostic significance in patients with acute pulmonary embolism. Thorax 60:956–961CrossRef
13.
Zurück zum Zitat Hollinshead WH (1971) Anatomy For Surgeons. New York: Harper & Row; 2nd Edition. Hollinshead WH (1971) Anatomy For Surgeons. New York: Harper & Row; 2nd Edition.
14.
Zurück zum Zitat Kagami H, Sakai H (1990) The problems in the arrangement of the azygos vein. Okajimaslia Anat 67(2–3):111–114CrossRef Kagami H, Sakai H (1990) The problems in the arrangement of the azygos vein. Okajimaslia Anat 67(2–3):111–114CrossRef
15.
Zurück zum Zitat Kanchana Latha G, Sugavasi R (2013) Study of the Azygos system of veins in human cadaver. Int J Cur Res Rev 05(08):115–117 Kanchana Latha G, Sugavasi R (2013) Study of the Azygos system of veins in human cadaver. Int J Cur Res Rev 05(08):115–117
16.
Zurück zum Zitat Krakowiak- Sarnowska E, Wisniewski M, Szpinda M, Krakowiak H (2003) Variability of the azygos vein system in human fetuses. Folia Morphol 62(4):427–430 Krakowiak- Sarnowska E, Wisniewski M, Szpinda M, Krakowiak H (2003) Variability of the azygos vein system in human fetuses. Folia Morphol 62(4):427–430
17.
Zurück zum Zitat Kutoglu T, Turut M, Kocabiyik N, Ozan H, Yildirim M (2012) Anatomical analysis of azygos vein system in human cadavers. Rom J Morphol Embryol 53(4):1051–1056PubMed Kutoglu T, Turut M, Kocabiyik N, Ozan H, Yildirim M (2012) Anatomical analysis of azygos vein system in human cadavers. Rom J Morphol Embryol 53(4):1051–1056PubMed
18.
Zurück zum Zitat Milne ENC (1973) Some new concepts of pulmonary blood flow and volume. Radiol Clin N Am 16:515–536 Milne ENC (1973) Some new concepts of pulmonary blood flow and volume. Radiol Clin N Am 16:515–536
19.
Zurück zum Zitat Milne ENC, Pistolesi M, Miniati M, Giuntini C (1984) The vascular pedicle of the heart and the vena azygos. Part I: the normal subject Radiology 152:1–8PubMed Milne ENC, Pistolesi M, Miniati M, Giuntini C (1984) The vascular pedicle of the heart and the vena azygos. Part I: the normal subject Radiology 152:1–8PubMed
20.
Zurück zum Zitat Moore KL, Dalley AF (1999) Clinically Oriented Anatomy, 4th edn. Lippincott Williams and Wilkins, Philadelphia Moore KL, Dalley AF (1999) Clinically Oriented Anatomy, 4th edn. Lippincott Williams and Wilkins, Philadelphia
22.
Zurück zum Zitat Nakahara K, Ohno K, Mastumura A, Hirose H, Mastuda H, Nakano R, Shirakura R, Kawashima Y (1989) Extended operation for lung cancer invading the aortic arch and superior vena cava. The Journal of Thoracic and Cardiovascular Surgery 97(3):428–433CrossRef Nakahara K, Ohno K, Mastumura A, Hirose H, Mastuda H, Nakano R, Shirakura R, Kawashima Y (1989) Extended operation for lung cancer invading the aortic arch and superior vena cava. The Journal of Thoracic and Cardiovascular Surgery 97(3):428–433CrossRef
23.
Zurück zum Zitat Nathan H (1960) Anatomical observations on the course of the azygos vein (vena azygos major). Thorax 15:229–232CrossRef Nathan H (1960) Anatomical observations on the course of the azygos vein (vena azygos major). Thorax 15:229–232CrossRef
24.
Zurück zum Zitat Patra A, Singla RK, Kaur H, Malhotra V (2019) Analysis of multiple variations in azygos venous system anatomy with its classification: a cadaveric study. Eur J Anat 23(1):9–15 Patra A, Singla RK, Kaur H, Malhotra V (2019) Analysis of multiple variations in azygos venous system anatomy with its classification: a cadaveric study. Eur J Anat 23(1):9–15
26.
Zurück zum Zitat Raghavendra AY, Bhosale SM (2017) Variations of arch of azygos vein: an anatomical overview with clinical importance. Int J Anat Res 5(32):4251–4256CrossRef Raghavendra AY, Bhosale SM (2017) Variations of arch of azygos vein: an anatomical overview with clinical importance. Int J Anat Res 5(32):4251–4256CrossRef
27.
Zurück zum Zitat Rokutanda T (1959) Nihonjin taiji ni okeru kijomyaku oyobi hannkijomyaku no jinsyu kaibogakuteki kenkyu. Kumamoto Igakukaishi 33:2168–2175 (in Japanese) Rokutanda T (1959) Nihonjin taiji ni okeru kijomyaku oyobi hannkijomyaku no jinsyu kaibogakuteki kenkyu. Kumamoto Igakukaishi 33:2168–2175 (in Japanese)
28.
Zurück zum Zitat Saito A, Murakami H, Tomioka K, Ezure H, Moriyama H, Mori R, Nakajima K, Nakamura M, Otsuka N (2015) The impact of aging on the course of the azygos vein. Okajimas Folia Anat Jin 92:7–10CrossRef Saito A, Murakami H, Tomioka K, Ezure H, Moriyama H, Mori R, Nakajima K, Nakamura M, Otsuka N (2015) The impact of aging on the course of the azygos vein. Okajimas Folia Anat Jin 92:7–10CrossRef
30.
Zurück zum Zitat Strandring S (2008) Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 40th Ed. Edinburgh: Elsevier Churchill Livingston, p 940. Strandring S (2008) Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 40th Ed. Edinburgh: Elsevier Churchill Livingston, p 940.
31.
Zurück zum Zitat Takasugi JE, Godwin JD (1990) CT appearance of the retroaortic anastomoses of the azygos system. AJR Am J Roentgenol 154(1):41–44CrossRef Takasugi JE, Godwin JD (1990) CT appearance of the retroaortic anastomoses of the azygos system. AJR Am J Roentgenol 154(1):41–44CrossRef
32.
Zurück zum Zitat Tatar I, Denk C, Celik H, Oto A, Karaosmanoglu D, Ozdemir B, Surucu S (2008) Anatomy of the azygos vein examined by computerized tomography imaging. Saudi Med J 29(11):1585–1588PubMed Tatar I, Denk C, Celik H, Oto A, Karaosmanoglu D, Ozdemir B, Surucu S (2008) Anatomy of the azygos vein examined by computerized tomography imaging. Saudi Med J 29(11):1585–1588PubMed
33.
Zurück zum Zitat Tateshi S (1939) Uber die Typen der V. azygos und V. hemiazygos. Nagasaki Igakkwai Zassi 17:2448–2455 (in Japanese) Tateshi S (1939) Uber die Typen der V. azygos und V. hemiazygos. Nagasaki Igakkwai Zassi 17:2448–2455 (in Japanese)
34.
Zurück zum Zitat Weijs TJ, Ruurda JP, Luyer MDP, Cuesta MA, van Hillegersberg R, Bleys RLAW (2017) New insights into the surgical anatomy of the esophagus. J Thorac Dis 9(Suppl 8):S675–S680CrossRef Weijs TJ, Ruurda JP, Luyer MDP, Cuesta MA, van Hillegersberg R, Bleys RLAW (2017) New insights into the surgical anatomy of the esophagus. J Thorac Dis 9(Suppl 8):S675–S680CrossRef
35.
Zurück zum Zitat Williams PL, Warwick R, Dyson M, Bannister LH (1989) Gray’s anatomy, 37th Edition, 754–755. Churchill Livingstone, London Williams PL, Warwick R, Dyson M, Bannister LH (1989) Gray’s anatomy, 37th Edition, 754–755. Churchill Livingstone, London
36.
Zurück zum Zitat Winer-Muram HT, Rydberg J, Johnson MS, Tarver RD, Williams MD, Shah H, Namyslowski J, Conces D, Jennings SG, Ying J, Trerotola SO, Kopecky KK (2004) Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography. Radiology 233(3):806–815CrossRef Winer-Muram HT, Rydberg J, Johnson MS, Tarver RD, Williams MD, Shah H, Namyslowski J, Conces D, Jennings SG, Ying J, Trerotola SO, Kopecky KK (2004) Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography. Radiology 233(3):806–815CrossRef
Metadaten
Titel
Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact
verfasst von
Konstantinos Koutsouflianiotis
Georgios Daniil
Georgios Paraskevas
Maria Piagkou
Chrysanthos Chrysanthou
Konstantinos Natsis
Publikationsdatum
03.10.2020
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 3/2021
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-020-02583-8

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