Spatio-temporal image correlation (STIC) imaging of an anomalous umbilical venous drainage to the right iliac vein

Spatio-temporal image correlation (STIC) imaging of an anomalous umbilical venous drainage to the right iliac vein | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 18 August 2025 V1 Latest version Share on Spatio-temporal image correlation (STIC) imaging of an anomalous umbilical venous drainage to the right iliac vein Authors : Mani Ram Krishna 0000-0003-1178-4288 [email protected] and Usha Nandhini Sennaiyan Authors Info & Affiliations https://doi.org/10.22541/au.175549159.97260610/v1 135 views 107 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Anomalies of the umbilical vein are increasingly recognized on prenatal ultrasound examination. Their hemodynamic importance as well as association with other anomalies are not completely understood yet. We report an unusual case of anomalous drainage of the umbilical vein to the right iliac vein and discuss its potential clinical implications Spatio-temporal image correlation (STIC) imaging of an anomalous umbilical venous drainage to the right iliac vein Mani Ram Krishna and Usha Nandhini Sennaiyan Dept of Pediatric Cardiology, Tiny Hearts Children’s Hospital Thanjavur Keywords: Umbilical-portal venous system, STIC imaging, systemic venous anomaly Correspondence to Dr Mani Ram Krishna Tiny Hearts Children’s Hospital 15-A, Selvam Nagar, Medical College Road, Thanjavur – 613007 E-mail: [email protected] Conflict of Interest: None Funding involved in the study: None Anomalies of the umbilical vein are increasingly recognized on prenatal ultrasound examination. Their hemodynamic importance as well as association with other anomalies are not completely understood yet. We report an unusual case of anomalous drainage of the umbilical vein to the right iliac vein and discuss its potential clinical implications A 22-year-old primigravida mother was referred to us for a fetal echocardiogram at 21 weeks gestational age. There was usual arrangement of the abdominal organs, and the heart was on the left side of the chest. The intra-cardiac anatomy was normal except for mild ventricular disproportion. The aortic arch was left sided and there was no substrate for coarctation. The inferior caval vein was dilated through its course (Fig 1 a and b). The umbilical vein and venous duct could not be imaged in the liver. There were two umbilical arteries and an umbilical vein visualized in the umbilical cord. The umbilical vein coursed adjacent to the right umbilical artery and drained into the inferior caval vein presumably via the right iliac vein (Fig 2 and b, Video 1 and 2). The venous channel was unobstructed Anomalies of the umbilical vein may be isolated or part of a broader subset of umbilical-portal venous system anomalies 1 . Anomalous drainage of the umbilical vein to the iliac vein has been reported only in a handful of cases 2-6 . The initial reports were based on an observation of unusual course of an umbilical venous catheter noted on radiography. However, a retrospective review of cases in a tertiary care center over a 14-year period reported two cases of anomalous umbilical vein drainage among 44 cases of umbilical-portal venous system anomalies identified on prenatal ultrasound 7 . Currarino and colleagues hypothesized that this may be due to a complete regression of both the umbilical veins with recanalization of a primitive connection between the umbilical veins and the cardinal venous system which is formed in the first 4-6 weeks of life and regresses spontaneously 2 . The umbilical vein and the venous duct carry oxygenated blood to the fetus. This blood is preferentially directed across the oval foramen to the left heart and from there to the upper body. This is not possible when the umbilical vein drains anomalously and may in part explain the mild ventricular disproportion noted on the fetal echocardiogram. This failure of redirection of oxygenated blood to the left heart has been implicated on intrauterine fetal growth restriction. As the umbilical vein is a structure which gets spontaneously occluded postnatally, this anomaly does not have any postnatal hemodynamic significance. However, this can be associated with hypoplasia or dysplasia of the portal venous system which may be difficult to recognize prenatally. The anomaly has been reported in association with Noonan syndrome 2,3 as well as Cornelia de Lange syndrome 5 suggesting that the presence of this abnormality could be part of a multi-system disorder References 1. Qin Y, Wen H, Liang M, et al. A new classification of congenital abnormalities of UPVS: sonographic appearances, screening strategy and clinical significance. Insights Imaging . Sep 6 2021;12(1):125. doi:10.1186/s13244-021-01068-52. Currarino G, Stannard MW, Kolni H. Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver. Pediatr Radiol . 1991;21(4):265–6. doi:10.1007/BF020186193. Leonidas JC, Fellows RA. Congenital absence of the ductus venosus: with direct connection between the umbilical vein and the distal inferior vena cava. AJR Am J Roentgenol . Apr 1976;126(4):892–5. doi:10.2214/ajr.126.4.8924. Fliegel CP, Nars PW. Aberrant umbilical vein. Pediatr Radiol . 1984;14(1):55–6. doi:10.1007/BF023867355. Toomayan GA, Gaca AM. Aberrant course of the umbilical vein in a newborn with Cornelia de Lange syndrome. Pediatr Radiol . Apr 2009;39(4):406–8. doi:10.1007/s00247-009-1164-26. White JJ, Brenner H, Avery ME. Umbilical vein collateral circulation: the caput medusae in a newborn infant. Pediatrics . Mar 1969;43(3):391–5. 7. Achiron R, Kivilevitch Z. Fetal umbilical-portal-systemic venous shunt: in-utero classification and clinical significance. Ultrasound Obstet Gynecol . Jun 2016;47(6):739–47. doi:10.1002/uog.14906 Figure Legends Fig 1 a – Two-dimensional fetal ultrasound image in the sagittal section demonstrating the inferior caval vein (IVC) dilated across its entire length Fig 1 b – Two-dimensional fetal ultrasound with color Doppler in the sagittal section demonstrating the course of the dilated inferior caval vein (IVC) Fig 2 a – Spatio temporal image correlation (STIC) image of the abdominal aorta demonstrating the umbilical arteries and umbilical vein. The umbilical vein courses along with the right umbilical artery caudally to drain into the ilical vein Fig 2 b- Spatio temporal image correlation (STIC) image of the anomalous umbilical venous drainage into the iliac vein as well as the dilated inferior caval vein (IVC) Video 2 – Spatio temporal image correlation (STIC) loop demonstrating the course of the umbilical vein along the right umbilical vein Video 2- Spatio temporal image correlation (STIC) loop demonstrating the anomalous umbilical venous drainage into the iliac vein as well as the dilated inferior caval vein Information & Authors Information Version history V1 Version 1 18 August 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords stic imaging systemic venous anomaly umbilical-portal venous system Authors Affiliations Mani Ram Krishna 0000-0003-1178-4288 [email protected] Tiny Hearts Children’s Hospital View all articles by this author Usha Nandhini Sennaiyan Tiny Hearts Children’s Hospital View all articles by this author Metrics & Citations Metrics Article Usage 135 views 107 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Mani Ram Krishna, Usha Nandhini Sennaiyan. Spatio-temporal image correlation (STIC) imaging of an anomalous umbilical venous drainage to the right iliac vein. Authorea . 18 August 2025. DOI: https://doi.org/10.22541/au.175549159.97260610/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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