Diagnostic procedure, CT-Angiography, CT, Thorax, Pulmonary vessels, Lung, Haemodynamics / Flow dynamics
C. F. Munoz-Nunez, D. Veiga-Canuto, L. F. Londoño-Villa, M. P. Calvillo, C. Fonfria, L. Trilles, A. Carreres; Valencia/ES
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.
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.
any pathologic condition of the pulmonary artery,
lung or pulmonary vein can cause asymmetric enhancement/nonenhancement of a pulmonary vein.
In our opinion,
we can extend the definition given by Souza et al to (a) any asymmetric enhancement/non-enhancement of the pulmonary veins in (b) a homogenously contrasted left atrium even in a non-CTPA chest CT (e.g.
standard chest CT).
The term “pulmonary vein sign” (PVS) has been recently coined by Souza et al in patients with clinical suspicion of acute pulmonary embolism (PE) evaluated with computed tomography pulmonary angiography (CTPA).
It is based on the theory that pulmonary arterial obstruction decreases venous drainage and defined by (a) presence of a homogeneous filling defect of at least 2 cm in a pulmonary vein and (b) attenuation of the left atrium >160 Hounsfield units Fig. 1