title: Identification of efferent flow in the superior vena cava and azygos vein confluence using cine phase-contrast MRI: speculation of the role of the azygos arch valves.
abstract: OBJECTIVE
  We aimed to evaluate flow patterns in the superior vena cava (SVC) and azygos vein confluence with cine phase-contrast magnetic resonance imaging with consideration for the role played by the azygos arch valves.
  
  
  METHODS
  Two-dimensional cine phase-contrast magnetic resonance images of the SVC and azygos vein confluence were prospectively acquired in 10 healthy volunteers. Flow directions during the cardiac cycle were evaluated quantitatively using sequential flow profile graphs obtained from each orthogonal image and affirmed visually by two radiologists from the oblique sagittal cine images.
  
  
  RESULTS
  Although the blood in the SVC and azygos vein confluence had an afferent flow during the systolic phase, a slight temporal efferent flow during the diastolic phase was quantitatively observed in all cases. Flow in the SVC can also be confirmed visually. The average velocity, average maximum afferent velocity during the systolic phase and average maximum efferent velocity during the diastolic phase of the SVC were 8.7 ± 2.4, 19.9 ± 3.7 and -1.0 ± 3.2 cm/s, respectively; for the azygos vein confluence, these values were 2.2 ± 1.5, 7.1 ± 2.6 and -1.5 ± 1.1 cm/s, respectively.
  
  
  CONCLUSIONS
  We verified that a slight temporal efferent flow exists in the SVC and azygos vein confluence during the diastolic phase, which suggests that the usual role of the azygos arch valves is to prevent this physiological retrograde flow.
authors.affiliation: Department of Radiology, Tokyo Women's Medical University Medical Center East, Tokyo 116-8567, Japan. i@imodey.com
authors.forename: Satoru
authors.initials: S
authors.lastname: Morita
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Ai
authors.initials: A
authors.lastname: Masukawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Kojima
authors.forename: Masami
authors.initials: M
authors.lastname: Hirata
authors.forename: Eiko
authors.initials: E
authors.lastname: Ueno
mesh_terms: D000328:Adult; D001401:Azygos Vein / Q000473:pathology*; D001783:Blood Flow Velocity; D003971:Diastole; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013599:Systole; D014683:Vena Cava, Superior / Q000473:pathology*; D055422:Venous Valves / Q000473:pathology*