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Il Giornale Italiano di Radiologia Medica 2018 Novembre-Dicembre;5(6):701-11

DOI: 10.23736/S2283-8376.18.00124-9


language: Italian

Superior and inferior vena cava congenital anomalies: clinical and therapeutic assessment

Vito ALBEROTANZA 1, Giuseppe DI GIOVANNI 2 , Pasquale PEDOTE 1, Pasquale PIGNATARO 1, Arnaldo SCARDAPANE 1, Amato A. STABILE IANORA 1

1 Sezione di Radiodiagnostica, Dipartimento Interdisciplinare di Medicina, Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italia; 2 Diagnostica per Immagini e Radiologia Interventistica, IRCCS De Bellis, Castellana Grotte, Bari, Italia


BACKGROUND: The aim of the study is to describe the different congenital anomalies of SVC and IVC detected incidentally, steer them from a clinical point and indicate in which cases they need monitoring or interventional therapy.
METHODS: We queried our electronic archive system from January 2017 by using keywords as: “venous vascular anomalies,” “anomalies inferior vena cava,” “interrupted vena cava,” “anomalies superior vena cava,” “azygos ectasia” and we recalled CT and MRI exams showed in the outcome. All examinations were performed without a dedicated protocol to study vascular anomalies because these were incidental findings, except in some cases in which venous anomalies were suspected, for example, because of the impossibility of introducing catheters in the IVC during a percutaneous closure of atrial septal defect. All data were retrospectively analyzed by two radiologists in consensus on a workstation (HPXW8600) equipped with an image reconstruction software (Vitrea FX 2.1, Vital Images, Minneapolis, MN, USA). Multiplanar, Maximum Intensity Projection and Minimum Intensity Projection reconstructions were used.
RESULTS: In our research we found incidental congenital anomalies of IVC and SVC in 0.8% of patients. In 1 case we found an atresia of the hepatic portion of the IVC with an azygos continuation. In 1 case, agenesis of the intrahepatic portion of the IVC associated with a porto-systemic shunt and an azygos continuation. In 3 cases we found a double IVC and left IVC. In 1 patient we found a complete agenesis of the superior vena cava.
CONCLUSIONS: VC anomalies are uncommon conditions often found as incidental findings in children or in adults. Awareness of these anomalies may be crucial and may have important clinical and therapeutic implications. Radiologist should be familiar with their appearance and, for that purpose, the knowledge of the embryogenesis may be helpful.

KEY WORDS: Vena cava, inferior, abnormalities - Vena cava, superior, abnormalities - Dilatation, pathologic

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