Distended azygos and hemiazygos vein without interrupted inferior vena cava in a case of agenesis of the ductus venosus

作者：H. Hille, R. Chaoui, Susanne Renz, Kurt Hecher · 发表于：Ultrasound in Obstetrics and Gynecology · 年份：2008 · DOI：10.1002/uog.5305 · 被引用次数：9 · 研究领域：Vascular anomalies and interventions、Renal and Vascular Pathologies、Pregnancy and preeclampsia studies

A 26-year-old woman, gravida 2 para 0, was referred for a detailed scan including uterine artery Doppler ultrasound examination, as her previous pregnancy ended in the intrauterine death of twins. Uteroplacental resistance in the index pregnancy was markedly increased with bilateral notching of the uterine artery waveform. At 26 weeks detailed fetal echocardiography showed normal cardiac structures. However, a blood vessel with venous flow velocity waveforms running in parallel to the thoracic aorta, which was classified as a distended azygos vein, was detected by color Doppler ultrasound imaging (Figure 1). The possibility of a heterotaxy syndrome could be excluded due to situs solitus and a non-interrupted inferior vena cava (IVC) (Figures 2-4). Furthermore, abnormal draining of the umbilical vein (UV) directly into the abdominal part of the IVC was detected (Figures 3 and 4). This was classified as agenesis of the ductus venosus (DV) with portocaval shunt, and was similar to that described in a recently published case1, 2. Posterior to this connection a collateral venous vessel originated from the IVC, joining the dilated hemiazygos vein on the left side of the abdominal aorta. In the thorax the hemiazygos vein crossed to the right, joining the azygos vein (Figure 5), before finally running into the superior vena cava. Color Doppler ultrasound examination showing distended azygos vein (red) posterior to the thoracic aorta (blue). Ultrasound scan showing normal four-chamber...