Topics

Topic

design image
Brachial veins

The brachial veins are paired deep veins of the upper limb, accompanying the brachial artery within the arm. They begin as the continuation of the radial and ulnar veins at the elbow (cubital fossa) and ascend the arm alongside the brachial artery. They terminate by uniting with the basilic vein to form the axillary vein near the inferior border of the teres major muscle.

The brachial veins are typically two in number (venae comitantes), running on either side of the brachial artery and interconnected by numerous transverse channels. Their close relationship with the brachial artery makes them an important part of the neurovascular bundle of the arm, alongside the median nerve.

Clinically, the brachial veins are important in upper-extremity deep vein thrombosis (DVT), venous access, and imaging of upper limb vascular pathologies.

Synonyms

  • Deep brachial veins

  • Venae comitantes of the brachial artery

Function

  • Drain venous blood from the arm (biceps, brachialis, humerus, and surrounding soft tissues)

  • Collect blood from the radial and ulnar veins of the forearm

  • Contribute to formation of the axillary vein, which continues into the subclavian vein

  • Provide deep venous return pathway parallel to the superficial venous system (cephalic and basilic veins)

Tributaries

  • Radial veins

  • Ulnar veins

  • Profunda brachii vein (deep brachial vein)

  • Venous branches from muscular tributaries and periosteal veins of the humerus

MRI Appearance

T1-weighted images:

  • Lumen appears as a signal void (black) due to flowing blood

  • Surrounded by hyperintense fat and hypointense brachial artery walls for localization

T2-weighted images:

  • Veins appear as signal voids unless thrombosed

  • Acute thrombus may appear hyperintense; chronic thrombus appears hypointense

STIR:

  • Suppresses fat to improve contrast between vein and adjacent soft tissue

  • Highlights perivascular edema or inflammatory changes

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Veins enhance homogeneously, allowing excellent visualization of lumen and patency

  • Non-enhancing regions indicate thrombosis or intraluminal masses

  • Useful for evaluating upper-extremity DVT, stenosis, or venous obstruction

MRA (MR Venography):

  • Contrast-enhanced MR venography demonstrates brachial veins and tributaries

  • Ideal for preoperative vascular mapping, DVT detection, and central venous planning

CT Appearance

Non-contrast CT:

  • Brachial veins are not easily distinguished from surrounding soft tissue

  • Can sometimes be inferred by location alongside the brachial artery

CT Post-Contrast (CT Venography):

  • Veins opacify brightly with intravenous contrast, running parallel to the brachial artery

  • Demonstrates patency, thrombosis, stenosis, or compression

  • Multiplanar and 3D reconstructions show detailed anatomy for surgical and interventional planning

  • Crucial for differentiating venous thrombosis from soft tissue or lymphatic pathology

CT images

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

CT images

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

MRI image

Brachial veins sag cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

CT image

Brachial veins ct axial