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Cases of high lying azygos arch and its embryological consideration

  • Anatomic Variations
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Abstract

Purpose

This study aimed to report cases of high-lying azygos arch and discuss the embryological basis of its development by a thorough evaluation of the anatomical features assessed using computed tomography (CT) images.

Methods

This study was approved by our institutional review board. We retrospectively reviewed chest CT images between November 2011 and November 2018. To determine high-lying azygos arch, we set the upper margin of the T4 vertebral body as the reference level. Regarding the embryological development of high-lying azygos arch, we retrospectively reviewed the CT images of 105 patients with tracheal bronchus to identify the location of the azygos arch.

Results

We noted that on three cases CT images, the azygos arch was located higher than the upper margin of the right main bronchus, and drained into the proximal superior vena cava (SVC) at a level higher than the conventional T4 or T5 vertebral level. All 105 patients with right tracheal bronchus showed azygos arch above the tracheal bronchus.

Conclusion

This variation in the location of the azygos arch can mimic pathological lesion on plain radiographs, and, therefore, it is important to be aware of high-lying azygos arch. Our findings show that the azygos arch may have possibly migrated downward during embryological development.

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Data availability

Please contact authors for data requests (Jin Young Yoo, M.D—email address: immdjy@gmail.com).

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chungbuk National University Hospital, Cheongju, Korea

    Min Young Yoo

  2. Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea

    Sung Jin Kim

  3. Department of Radiology, Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju-si, 362-711, Chungcheongbuk-do, Korea

    Sung Jin Kim & Jin Young Yoo

Authors
  1. Min Young Yoo
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  2. Sung Jin Kim
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  3. Jin Young Yoo
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Contributions

MYY: data collection, data analysis, manuscript writing; SJK: data collection and management, data analysis, manuscript writing editing; JYY: project development, data collection and management, data analysis, manuscript writing and editing.

Corresponding author

Correspondence to Jin Young Yoo.

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The authors declare that they have no conflict of interest.

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The study was approved by the institutional review board and the requirement for informed consent was waived because of the retrospective study design.

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Yoo, M.Y., Kim, S.J. & Yoo, J.Y. Cases of high lying azygos arch and its embryological consideration. Surg Radiol Anat 43, 363–366 (2021). https://doi.org/10.1007/s00276-020-02570-z

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  • DOI: https://doi.org/10.1007/s00276-020-02570-z

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