Computed tomography manifestations of common inferior vena cava dysplasia and its clinical significance

Abstract

This study aimed to review and analyse the computed tomography (CT) imaging results of frequently encountered developmental anomalies of the inferior vena cava (IVC). The underlying clinical significance was evaluated with reference to the relevant literature. CT images of patients who received abdominal or thoracic scanning between July 2009 and September 2011 were reviewed. Developmental anomalies observed in the IVC were identified and categorised. Images of the cases with typical anomalies were presented and their developmental mechanism, as well as clinical significance, was discussed. The most frequently encountered IVC developmental anomalies include the left vena cava, double vena cava, azygos continuation of the IVC, left circumaortic renal vein, left retroaortic renal vein and retrocaval ureter. The embryogenesis of the IVC is a complex process that results in various congenital anomalies. The developmental anomalies of the IVC are distinguished using a CT scan and have significant implications on clinical perspective.

Vena Cava and Left Renal Vein Variations and Association with Other Anomalies Including Horseshoe Kidney

“…Superior vena cava (SVC), inferior vena cava (IVC) and left renal vein (LRV) variations are not rare at all, and they have been diagnosed with an ever-increasing rate (1)(2)(3)(4). Vena cava variations may stay asymptomatic throughout a lifetime (4). Knowing the presence of these variations will affect morbidity and mortality in patients undergoing operations and interventional procedures.…”

“…Knowing the presence of these variations will affect morbidity and mortality in patients undergoing operations and interventional procedures. So, it is very important that the radiologists be aware of these variations (1,2,4,5).…”

“…Among the whole group of vena cava variations, there are some that are encountered rather more frequently, but the spectrum of variations is rather wide due to the complicated phases of embryologic development (4,6). Despite the difficulties of categorization, there is a rather simple method of classification (Box 1).…”

A Computational Method for Predicting Inferior Vena Cava Filter Performance on a Patient-Specific Basis

“…Though other studies have noted naturally-occurring recirculation regions downstream of the renal inflow in normal IVC anatomy [22,21], this is the first report of flow recirculation in the infrarenal IVC. This may be clinically significant, as higher occurrence rates of DVT have been reported in patients with IVC anomalies [23,24,25,26,27,28,29]. Near-stagnant, recirculating flow also occurred downstream of the IVC filter following embolus placement in each patient IVC, with larger recirculation regions in the left-sided IVC.…”

“…Specifically, after obtaining Institutional Review Board exemption (Penn State), veins were imaged with 0.87 mm per pixel in-plane resolution and 1.5 mm per pixel out-of-plane resolution [18]. Two IVC anomalies were chosen, in part to investigate their possible association with DVT [23,24,25,26,27,28,29]: a left-sided IVC (0.2-0.5% of the population) and an IVC with a retroaortic left renal vein (1.7-3.4% of the population) [6]. While these specific anomalies represent less than 5% of the population, the overall incidence of renal vein anomalies is much higher (about 20-30% [30]).…”