Aplasia of the Inferior Caval Vein with Azygos Continuity
Clinical details
Unclear congestion syndrome of both legs in a 12 year-old adolescent; symptomatic for many years. An MR angiography was performed following a bilateral leg phlebography.
Summary of findings
Massive retroperitoneal and paravertebral collateral vessels were found as a result of aplasia or occlusion of the infrarenal inferior vena cava. Partial connection of these vessels with the Suprarenal inferior vena cava and portal vein.
Diagnosis
In addition to an aplasia of the Infrarenal vena cava inferior, an older thrombotic plug is also possible.
Description of images
[1 – 2] Steady-state Imaging after Gadofosveset; shows iliac and retroperitoneal venous collateral convolutes, draining into the paravertebral venous plexus (arrows).
[3] Image 3 shows efflux through the portal vein and the strongly reactively hypertrophied inferior mesenteric vein.
[4] A supplementary balanced FFE image was also made showing the massively enlarged azygos vein (arrow).
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