Central venous stenosis of left versus right arm: Its prevalence and effects on image quality in CT of the neck

Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output

“…Previous studies suggest that there is a physiologic stenosis of the left brachiocephalic vein as it crosses between the sternum and great vessels resulting in increased venous stasis and reflux. 19,29 The left brachiocephalic vein also exhibits a longer course to the heart than the right. These factors may alter the volume and rate of contrast delivery to the heart, decreasing peak opacification with LSI because contrast pooling in the central venous system from reflux is known to negate improvements in vessel opacification from increasing contrast injection flow rates.…”

“…It is known that LSI results in increased perivenous artifacts and venous reflux in the neck, adversely affecting the quality of images. 18,19 However, studies on RSI versus LSI on vessel opacification have been equivocal. You et al 18 reported a nonsignificant trend for increased opacification in common carotid arteries with RSI, while Grimm et al 28 found no differences in HU values of the pulmonary arteries.…”

“…1). [16][17][18][19][20] However, little work has been performed proving that RSI results in improved cervical and intracranial intra-arterial opacification. Only 1 study has examined the effects of left-sided versus right-sided contrast injection on cervical vessel opacification, which demonstrated a nonsignificant trend for higher attenuation values in the carotid arteries with RSIs.…”

Vertebral Venous Congestion That May Mimic Vertebral Metastasis on Contrast-Enhanced Chest Computed Tomography in Chemoport Inserted Patients

“…Nevertheless, in a few patients, VVC occurred even when the contrast medium was injected on the contralateral side of the chemoport, particularly when the contrast material was injected via the left arm. Previous studies have shown that prominent venous reflux after left arm injection occurs because of physiological narrowing of the left central vein by other anatomical structures (such as clavicle, sternum, aortic arch, or its branches), the long contrast pathway through the left arm, or abnormalities of the left internal jugular vein valve [ 28 29 ]. Overall, injecting contrast contralaterally to the chemoport site is preferred to prevent VVC; however, exceptions may apply in specific cases, such as in patients with breast cancer requiring protection of the upper extremity venous system.…”

Innominate Vein Stenosis in Breast Cancer Patients after Totally Implantable Venous Access Port Placement

“…Hernández et al defined the criteria for venous stenosis when there was evidence of unequivocal strictures (more than 30% narrowing of the vessel lumen diameter) with or without collateral circulation on venogram (14). Based on CT images, several authors have measured the retrosternal distance (the shortest distance between the sternum and the arch or its branches) (15) or the narrowest diameter of the left innominate vein in the retrosternal area (16) or measurements of the cross-sectional area of the vein at the narrowest point, which could be more accurate than one-dimensional diameter measurements (17) for the direct proof to central vein stenosis. In this study, stenosis was defined as a significant reduction (>75%) of the visible full length of the vein diameter on axial images.…”