CTICasesLeft superior intercostal vein dilation from venous thrombosis
Imaging findings
Chest CT in a patient with sickle cell disease and a history of venous thrombosis demonstrates a markedly dilated left superior intercostal vein (forming a prominent aortic nipple on radiograph) and a dilated azygos vein, serving as collateral pathways in the setting of chronic central venous occlusion and indwelling catheters.
Key takeaways
Dilation of the left superior intercostal vein is a key collateral pathway in central venous obstruction. It is the left-sided equivalent of the azygos arch and can be recognized radiographically as an enlargement of the aortic nipple.
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