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Left superior intercostal vein opacification

Case contributed by Dr Prashant Gupta


non specific cough

Patient Data:

Age: 63
Gender: Female
Race: Indian/Pakistani
Modality: CT

Note the opacified left superior intercostal vein (LSICV)- its position correlates with the aortic "nipple" that is seen on chest X rays.

It is seen to drain into the acccessory hemiazygous to left of midline which in turn drains into the azygous system after crossing the midline.

Case Discussion:

Opacification and more importantly dialtion of azygous and accessory systems usually indicates venous obstruction of some kind, in this case there was none.

At times if the contrast density in the LSICV is similar to the aorta its curvilinear course near the arch can mimic a dissection flap- the so called "pseudo dissection".

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