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Related Experiment Videos

Postaortic left innominate vein: radiological assessment and pathogenesis

M Minami1, M Noda, N Kawauchi

  • 1Department of Radiology, University of Tokyo Hospital, Japan.

Clinical Radiology
|July 1, 1993
PubMed
Summary

Postaortic left innominate vein (PALIV) is a rare anomaly. Plain chest X-rays showing a high aortic arch and mediastinal shadows suggest PALIV, confirmed by CT or MRI.

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Area of Science:

  • Radiology
  • Vascular Anatomy
  • Medical Imaging

Background:

  • Postaortic left innominate vein (PALIV) is an uncommon venous anomaly.
  • Radiographic findings of PALIV on plain chest X-rays are not well-established.

Purpose of the Study:

  • To describe the plain chest radiographic findings associated with PALIV.
  • To correlate radiographic findings with CT and MR imaging in patients with PALIV.

Main Methods:

  • Retrospective review of plain chest radiographs, CT, and MR imaging in nine adult patients with known PALIV.
  • Analysis of aortic arch position and mediastinal shadowing on radiographs.
  • Confirmation of venous anomaly and aortic arch/innominate artery position with cross-sectional imaging.

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Main Results:

  • All patients exhibited a high aortic arch on plain radiographs, with variations including right-sided or double aortic arches.
  • Seven patients showed curved shadows in the left upper mediastinum.
  • Lateral radiographs revealed opacification of the superior retrosternal region by the high aortic arch.
  • CT/MR confirmed the aortic arch and/or innominate artery occupying the space typically housing the left innominate vein.

Conclusions:

  • A combination of a high aortic arch and a curved superior mediastinal shadow on plain chest radiographs is suggestive of PALIV.
  • CT and MR imaging are definitive for diagnosing PALIV.
  • Developmentally, PALIV appears to be secondary to an elevated aortic arch position.