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

Surg Radiol Anat. 2021 Mar;43(3):353-361. doi: 10.1007/s00276-020-02583-8. Epub 2020 Oct 3.

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.

Keywords: Anatomy; Azygos vein; Computed tomography angiography; Morphometry; Variation.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anatomic Variation*
  • Azygos Vein / anatomy & histology*
  • Azygos Vein / diagnostic imaging
  • Computed Tomography Angiography
  • Dyspnea / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tachycardia / diagnosis
  • Vena Cava, Superior / anatomy & histology*
  • Vena Cava, Superior / diagnostic imaging
  • Young Adult