Application of CT in the diagnosis of partial anomalous pulmonary venous connection

Abstract

Objective To systematically describe the imaging features and clinical correlates of partial anomalous pulmonary venous connection diagnosed on computed tomography (CT) in adults. Methods Twenty - nine adults with partial anomalous pulmonary venous connection on CT were retrospectively identified. There were 19 women and 10 men, with a mean age of 41 (range:19 -55) years. Chest radiographs (25 of 29 cases) were reviewed for mediastinal contour abnormalities,heart size, and pulmonary vascular pattern. Chest CT scans were reviewed for location, size, and drainage site of the anomalous vein; presence or absence of a pulmonary vein in the normal location; cardiac size and configuration ; and pulmonary vasculature. Results Sev-enty -nine percent (23 of 29 patients) had an anomalous left upper lobe vein connecting to a persistent left vertical vein, only 5% (1 of 23 patients) of whom had a left upper lobe vein in the normal location. Seventeen percent (5 of 29 patients) had an anomalous right upper lobe vein draining into the superior vena cava, 60% (3 of 5 patients) of whom also had a right upper lobe pulmonary vein in the normal location. One patient (3%) had an anomalous right lower lobe vein draining into the suprahe-patic inferior vena cava. Chest radiographic findings were abnormal left mediastinal contour in 64% (15 of 25 patients), abnor-mal right mediastinal contour in 8% (2 of 25 patients), and cardiomegaly in 24% (6 of 25 patients). Computed tomography findings were cardiomegaly in 48% (14 of 29 patients), right atrial enlargement in 31% (9 of 29 patients), right ventricular en-largement in 31% (9 of 29 patients), and pulmonary artery enlargement in 14% (4 of 29 patients). Conclusion The anoma-lous vein in adults are most commonly from the left upper lobe, in women, and infrequently associate with atrial soptal defects. Key words: Computed tomography; Diagnosis; Adult; Partial anomalous pulmonary venous connection