E3458. A Comprehensive Review of the Thoracic Venous Anomalies
  1. Seyed Mohammad Hossein Tabatabaei; University of California, Los Angeles
  2. Ashley Prosper; University of California, Los Angeles
  3. Sean Johnson; University of California, Los Angeles
Congenital anomalies affecting the thoracic veins are uncommon yet significant. Their spectrum ranges from cases displaying entirely normal physiology to those involving substantial right-to-left shunting, necessitating surgical intervention. Radiologists play a pivotal role in identifying and characterizing these anomalies, utilizing advanced imaging techniques such as multidetector CT (MDCT) and MRI. This exhibit aims to enhance understanding the role of MDCT and MRI in assessment of thoracic venous anomalies. It also provides classification of all types of thoracic venous anomalies based on the involvement of either systemic or pulmonary veins.

Educational Goals / Teaching Points
Illustrate the imaging features of various types of thoracic venous anomalies, and briefly review on the embryology and differential diagnosis. Reviewing the importance of a complete understanding of the anatomy of these anomalies from a surgical viewpoint.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review of the imaging modalities for evaluation of thoracic venous anomalies: pros and cons of radiography, MDCT, and MRI. The importance of detecting and fully describing thoracic venous anomalies. Classification of thoracic venous anomalies - systemic veins, Azygos system, Absent azygos vein, Azygos lobe, Azygos continuation of IVC, Hemiazygos continuation of IVC, Superior Vena Cava, left-sided SVC, Duplication of SVC, Aberrant insertion of SVC, Other anomalies - Retroaortic left Brachiocephalic vein, left-sided IVC. Pulmonary veins: partial anomalous pulmonary venous return - supracardiac, cardiac, infracardiac, mixed. Total anomalous pulmonary venous return, right pulmonary veins, left pulmonary veins. Other anomalies - pulmonary varix. An algorithmic approach to thoracic venous anomalies. Reviewing some cases after surgical repair.

Congenital anomalies of the thoracic veins, though infrequent and often asymptomatic, can carry significant clinical implications and potential risks. The ability to accurately assess pulmonary venous anatomy, including variants and anomalies, is essential for effective clinical decision-making and planning interventions. The recognition of these anomalies is crucial not only for guiding patient management but also for addressing the diagnostic complexities posed by these conditions