MR imaging of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein in the fetus

Su-Zhen Dong,Ming Zhu

doi:10.1038/s41598-018-33033-6

Su-Zhen Dong, Ming Zhu

Open Access

https://doi.org/10.1038/s41598-018-33033-6

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Journal: Scientific Reports	Publication Date: Oct 3, 2018
Citations: 12	License type: open-access

Affiliation: Shanghai Children's Medical Center

Abstract

The purpose of this study was to report fetal cases of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein (LBCV) evaluated by fetal cardiac magnetic resonance imaging (MRI). A retrospective review of 7282 fetal cardiac MRI from June 2006 to March 2017, nine cases of anomalous courses of the LBCV were correctly diagnosed by fetal cardiac MRI, one case of abnormal subaortic left brachiocephalic vein (ASLBV) missed by fetal MRI was identified postnatally during further imaging of the TOF. The diagnosis was confirmed postnatally by cardiac CT/MRI. An ASLBV was found in 8 cases, a retroesophageal LBCV was found in 2 additional cases with right aortic arch and aberrant left subclavian artery. 3 of 8 ASLBV cases were with a right aortic arch, 4 ASLBV cases had additional cardiovascular anomalies with one case isolated. 7 of 8 ASLBV and 2 retroesophageal LBCV were correctly diagnosed by fetal cardiac MRI; however fetal cardiac MRI missed 2 cases of associated pulmonary atresia (PA). Prenatal echocardiography (echo) correctly diagnosed five ASLBV and one retroesophageal LBCV as well as associated intracardiac anomalies. Fetal cardiac MRI can be a useful adjunct in the identification of subaortic and retroesophageal anomalous courses of the LBCV prenatally.

Highlights

The left brachiocephalic vein (LBCV) is formed by the junction of the left subclavian and left jugular veins in the superior mediastinum
7282 fetal cardiac magnetic resonance imaging (MRI) were reviewed and 81 postnatal MRI/CT were reviewed for the presences of LBCV. 9 of 10 fetal cases with abnormal course of the LBCV were identified by fetal cardiac MRI and confirmed by postnatal MRI/CT, 1 of 10 fetal case with abnormal course of the LBCV was only identified by postnatal MRI during further imaging of the tetralogy of Fallot (TOF) with right aortic arch (RAA)
In 2 cases of retroesophageal LBCV identified by fetal MRI, the LBCV passed posterior to the esophagus, joining the azygos vein into the right sided superior vena cava (RSVC) (Fig. 2)

Summary

Introduction

The left brachiocephalic vein (LBCV) is formed by the junction of the left subclavian and left jugular veins in the superior mediastinum It receives venous return from the head, neck and left upper extremities. The normal course of the LBCV is obliquely downward, passing superior and anterior to the aortic arch and posterior to the thymus gland, joining the right brachiocephalic vein to form the right sided superior vena cava (RSVC) (Fig. 1). The LBCV courses posterior to the esophagus, joining the azygos vein draining into the superior vena cava. This is known as a retroesophageal or retrotracheal LBCV3,4.

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