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
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 sign can be seen in the veins draining the areas of fibrosis pointing out to the vascular damage in this diseases preventing a good return of blood to the heart.
The absence of the pulmonary artery as is the case in pulmonary artery agenesis can cause the PVS Fig. 7 and hemodynamically it is simple to understand why.
The displacement of the inferior pulmonary veins and the basal atelectasis secondary to diaphragmatic palsy or eventration can also cause the PVS Fig. 8
The PVS must be differentiated from pulmonary vein thrombosis either non-neoplastic Fig. 9 and Fig. 10 or neoplastic Fig. 11.
Also the pulmonary vein stenosis after ablation or surgery must be differentiated from the PVS Fig. 12.
Some artifacts do to poor enhancement of the left atrium can give features similar to the PVS,
but it must me remembered that to use this sign it is necesssary an homogeneous enhancement of the left atrium Fig. 13