Learning objectives
1.
To review the description of the “pulmonary vein sign”.
2.
To review the various etiologies of the “pulmonary vein sign”.
Background
This sign was previously introduced by Saffar and Gupta as the “dark pulmonary vein sign” and described not only in PE (54%) but also in other pathologies (e.g.
atelectasis,
consolidation and infiltrates).
Hassani and Saremi pointed out that an asymmetric enhancement/nonenhancement of a pulmonary vein can be the result of several factors and any pathologic condition increasing the pulmonary resistance can reduce the pulmonary venous return.
Therefore,
any pathologic condition of the pulmonary artery,
lung or pulmonary vein can cause asymmetric enhancement/nonenhancement of a pulmonary...
Imaging findings OR procedure details
The PVS more commonly is seen in cases of acute pulmonary embolism Fig. 2 and can also bee seen in cases of chronic thromboembolic pulmonary disease Fig. 3
Among the pulmonary causes of the PVS there are focal and diffuse diseases.
Focal etiologies of the sign are atelectasis Fig. 4 and pneumonia.
Lung cancer can also cause the sign when there is severe obstruction or occlusion of the pulmonary arteries Fig. 5.
Lung fibrosis can also produce the sign Fig. 6,
in lung fibrosis the...
Conclusion
Although the “pulmonary vein sign” has been described in cases of PE using CTPA with high specificity,
it can also be seen in other conditions even on non-CTPA.
When present,
this sign should be considered abnormal and direct our attention to rule-out an ipsilateral lung disease.
References
1.
Souza LV,
Zanon M,
Souza AS,
Irion K,
Penha D,
Alves GR,
et al.
"Pulmonary Vein Sign" for Pulmonary Embolism Diagnosis in Computed Tomography Angiography.
Lung.
2017 Oct;195(6):769-774.
2.
Ermin S,
Çinkooğlu A,
Susam S,
Batum Ö,
Yılmaz U.
A new perspective for pulmonary thromboembolism radiology: ‘Pulmonary vein sign’.
Clin Respir J.
2018 Nov;12(12):2653-2658.
3.
Saffar B,
Gupta A.
The dark pulmonary vein sign.
RANZCR Annual Scientific Meeting 2011,
October 6-9; Melbourne/AU.
4.
Hassani C,
Saremi F.
Comprehensive Cross-sectional Imaging of the Pulmonary Veins....