40 year-old male with dyspnea

 

Images

Doctor's Information

Name : Noshin
Family :Shirvandehi
Affiliation : Chamran Hospital
Academic Degree: Head of Radiolgy Department of Chamran Hospital
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Ramin Pourghorban

 

Patient's Information

Gender : Male
Age : 40

 

Case Section

Cardiovascular

 

Clinical Summary

40 year-old male with dyspnea

 

 

Imaging Findings

Reformatted oblique- axial and oblique-coronal images (images1-2) demonstrate stenosis of right superior pulmonary vein. Oblique-coronal MIP (images3-4) and 3D volume rendering images (images5-7) also confirm the finding. Other pulmonary veins are unremarkable and have normal appearance.

 

Discussion (Related Text)

Kim Y.H. et al found that the pulmonary veins, particularly the left-sided veins, and ostia were typically oval and not round. This suggests that planar pulmonary venography may not be an optimal technique for determining the size of the multipolar loop catheter. CT or MR imaging with multiplanar reformatted images should better depict the cross-sectional area and profile of the venous ostium. They also noted that the left inferior pulmonary vein normally narrows as it enters the atrium; thus, particular care must be taken when this vein is evaluated for stenosis at CT. The ostial diameters of pulmonary veins are quite variable: 11.4??12.4 mm for the right superior pulmonary vein, 9.6??10.5 mm for the left superior pulmonary vein, 12.3??13.1 mm for the right inferior pulmonary vein, and 9.0??9.9 mm for the left inferior pulmonary vein. The right and left superior pulmonary veins and the right inferior pulmonary vein show a gradual and continuous increase in diameter and cross-sectional area as the veins approached the left atrium. The normal left inferior pulmonary vein, however, have somewhat different characteristics. The cross-sectional area and diameter of the left inferior pulmonary vein typically increase to a point 15 mm from the atrial ostium and then gradually decrease as the vein enters the left atrium. This proximal decrement in diameter and cross-sectional area is statistically significant.

 

 

Final Diagnosis

Right Superior Pulmonary Vein Stenosis

 

References

Kim YH, Marom EM, Herndon JE, McAdams HP. Pulmonary Vein Diameter, Cross-sectional Area, and Shape: CT Analysis. Radiology 2005; 235:43-49.

 

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