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Axillary veins

The axillary vein is the major vein of the upper limb that drains blood from the arm, axilla, and shoulder girdle. It begins at the lower border of the teres major muscle as the continuation of the brachial veins, and ascends medially and anteriorly to the axillary artery. It terminates at the lateral border of the first rib, where it becomes the subclavian vein.

The axillary vein receives numerous tributaries including the basilic vein, cephalic vein, and veins accompanying branches of the axillary artery. It has thin walls and lies in close relation to the axillary artery and brachial plexus cords, making it clinically significant in trauma, central venous access, and thoracic outlet syndrome.

Anatomically, the axillary vein is divided into three parts according to its relation to the pectoralis minor muscle:

  • First part: from the lateral border of teres major to lower border of pectoralis minor

  • Second part: posterior to pectoralis minor

  • Third part: from upper border of pectoralis minor to lateral border of the first rib

Synonyms

  • Vena axillaris

  • Upper limb central vein

Function

  • Drains venous blood from the upper limb, axilla, and shoulder

  • Acts as a continuation of brachial veins and transitions into the subclavian vein

  • Provides venous access for catheterization and central venous lines

  • Plays a role in collateral venous drainage of thoracic outlet and shoulder

Tributaries

  • Brachial veins

  • Basilic vein

  • Cephalic vein (via deltopectoral groove)

  • Thoracoacromial, subscapular, circumflex humeral, and lateral thoracic veins

MRI Appearance

T1-weighted images:

  • Lumen appears as a signal void (black) due to venous flow

  • Surrounded by hyperintense fat planes, aiding localization

T2-weighted images:

  • Normal venous lumen is a signal void; intraluminal thrombus may show variable high signal intensity depending on clot stage

STIR:

  • Suppresses fat to highlight the venous walls and perivascular tissue

  • Useful for detecting edema, inflammation, or extrinsic compression

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Axillary vein enhances homogeneously with intravenous contrast

  • Filling defects correspond to deep vein thrombosis (DVT) or intraluminal masses

  • Useful in MR venography for thoracic outlet syndrome or thrombosis mapping

MRI Non-Contrast Cardiac/Respiratory-Gated 3D Imaging:

  • Provides 3D visualization of the venous pathway from brachial to subclavian transition

  • Useful in patients where contrast is contraindicated

CT Appearance

CT Post-Contrast (CT Venography):

  • Axillary vein lumen opacifies brightly with intravenous contrast

  • Demonstrates origin, course, and tributaries

  • Detects stenosis, thrombosis, extrinsic compression, or catheter-related complications

  • Multiplanar and 3D reconstructions helpful in pre-surgical or interventional planning

CT images

Axillary veins anatomy axial CT image -img-00000-00000

CT images

Axillary veins anatomy coronal CT image -img-00000-00000

MRI image

Axillary veins anatomycoronal mri image -img-00000-00000

CT image

Axillary vein ct axial image

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Axillary vein ct coronal

MRI image

Axillary vein