J Korean Soc Radiol.  2013 Aug;69(2):139-142. 10.3348/jksr.2013.69.2.139.

Variation of Internal Mammary Vessels: Vein Lateral to Artery: Two Cases

• Lee JH
• Han DH

• KMID: 2208817
• DOI: http://doi.org/10.3348/jksr.2013.69.2.139

Abstract

Congenital variations of the internal mammary vascular anatomy are rare and may be encountered during various percutaneous transthoracic procedures. Hereby, we present two cases of congenital variations of the internal mammary vessel incidentally found on CT, with the vein entirely or partially lying lateral to the artery in the first intercostals space. The imaging findings and the clinical implications of these rare anatomical variations are being presented.

MeSH Terms

Arteries
Deception
Glycosaminoglycans
Veins
Glycosaminoglycans

Figure

• 

  Fig. 1 A 25-year-old female with a palpable supraclavicular mass. A. Coronal maximum-intensity-projection CT image of a 25-year-old female (Case 1). The right (arrowheads) and left internal mammary arteries run laterally to their concomitant veins (arrows) in the first intercostals space, above which the vein cross over the arteries to join the brachiocephalic veins (B). B. CT scan shows a biopsy needle (arrowhead) advanced lateral to internal mammary vessels (arrow) into an anterior mediastinal mass, which was subsequently confirmed as diffuse large B cell lymphoma. Note.-I = innominate artery

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  Fig. 2 Coronal maximum-intensity-projection CT image of a 73-year-old male with a lung mass (Case 2). The right internal mammary artery (IMA; white arrow) is running medially to the right internal mammary vein (IMV; arrowhead) in the first intercostal space. The left IMV (black arrow) crosses over the left IMA (vein anterior to artery on axial plane) in the middle of the first intercostal space.

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  Fig. 3 Four patterns of IMV anatomy. Modified from Arnez ZM, Valdatta L, Tyler MP, Planinsek F. Br J Plast Surg 1995;48:540-545 (1). Blue: internal mammary vein. Red: internal mammary artery. (A) Type 1. (B) Type 2. (C) Type 3. (D) Type 4. Type 1 and 3: a single IMV lying medial (lateral) to the IMA dividing into two tributaries usually at the level of the 3rd or 4th intercostal space. Type 2 and 4: a single IMV runs medially (laterally) to the artery throughout its course, with no divisions. Note.-IMA = internal mammary artery, IMV = internal mammary vein

Reference

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