On an axial contrast-enhanced CT of the chest obtained at the level of the thoracic inlet, just above the aortic arch, a venous channel is seen crossing from left to right, lying anterior to the trachea and the brachiocephalic arteries, to join the superior vena cava. Which vessel is this?

• A Left superior intercostal vein
• B Left inferior pulmonary vein
• C Left brachiocephalic vein ✓
• D Arch of the azygos vein

Explanation

The left brachiocephalic vein is formed behind the left sternoclavicular joint and courses obliquely across the superior mediastinum, passing anterior to the trachea and the origins of the brachiocephalic arteries, to unite with the right brachiocephalic vein and form the SVC. The azygos arch lies on the right side and enters the SVC posteriorly at the tracheobronchial angle. The left superior intercostal vein arches around the aortic arch much more caudally.

Reference: Webb, Higgins: Thoracic Imaging, Pulmonary and Cardiovascular Radiology, 3rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.