Learning objectives
describe the embryological development of the superior and inferior venae cavae
review the spectrum of congenital variations of the venae cavae
highlight relevant CT findings of the most important anatomical variations and pathologies that can affect the two veins
illustrate possible diagnostic pitfalls
Background
Both superior and inferior vena cava may be associated with many congenital variants and pathological processes. However, these structures are often sidelined both clinically and in imaging studies.
CT is a useful modality to evaluate abnormalities of the venae cavae because of its ability to quickly generate volumetric data for multiplanar reformation. MDCT is the most common imaging technique for initial evaluation of vena cava variants and pathological findings.
Findings and procedure details
Normal Development or Embryogenesis
At 4 weeks of life, 3 distinct venous systems form: the vitelline system drains the gut, the umbilical system drains the placenta, and the cardinal system drains the rest of the embryo. The cardinal veins are divided into anterior and posterior cardinal veins, joining to form the common cardinal veins, which drain into the sinus venosus.
The superior vena cava is formed from the right anterior and the right common cardinal veins.
The inferior vena cava develops through a complex pattern...
Conclusion
Pathologies of superior and inferior vena cava can have significant clinical implications, therefore evaluation of these structures must be a integral part of the search pattern. Recognizing the pathological conditions of the two veins can be vital to patient care. Using CT offers the possibility to make a correct diagnosis based on three-dimensional reconstructions.
Personal information and conflict of interest
A. Tacu; Bucharest/RO - nothing to disclose A. V. V. Marinescu; Bucharest, ROMÂNIA/RO - nothing to disclose A. Nicula; Bucharest/RO - nothing to disclose A. N. Marinescu; Bucharest/RO - nothing to disclose G. Iana; Bucharest/RO - nothing to disclose
References
1.Arslan G, Ozkaynak C, Cubuk M, Sindel T, Luleci E. Absence of the azygous vein associated with double superior vena cava.The Journal of Vascular Diseases.1999 Jan;50(1):81–4.
2.Saha S, Paoletti D, Robertson M. Persistent left superior vena cava – considerations in fetal, pediatric and adult populations. AJUM. 2012;15:61-66.
3.Albay S, Cankal F, Kocabiyik N, Yalcin B, Ozan H. Double superior vena cava.Morphologie.2006 Mar;288:39–42.
4.Savader SJ, Ronsivalle JA. Permanent inferior vena cava filters. In: Savader SJ, editor. Venous interventional radiology with clinical perspectives. 2nd ed. New York:...