Evaluation of Pulmonary Vein Variations Using Multidetector Computed Tomography

Objective: In this study, we aimed to identify variations in pulmonary veins (PVs) that are important for preparation before a radiofrequency ablation (RFA) using 64 multidetector computed tomography (MDCT) and to classify their incidence and drainage types.Methods: In total, 503 patients, including 312 males and 191 females who were examined by abdominal computed tomographyangiography for various reasons between January 2011 and December 2016 were included in this study. A 64-section CT devicewas used for scanning. Two-dimensional multiplanar reformats were created from axial images, and 3-dimensional images werecreated using maximum intensity projection and volume rendering methods. PV anatomic variations were identified.Results: A pulmonary venous drainage pattern with the classical pattern, i.e., four ostia with two ostia on the right and two on theleft, was observed in 44.8% of the patients. The remaining patients had varying anatomies on the right or on the left. In addition,3.4% had right top PV, 72.4% had the classical type with two ostia on the right, whereas 27.6% had the varying type with oneostium or more than two ostia on the right. In addition, 61.5% had the classical pattern with two atrial ostia on the left, whereas38.5% had the varying drainage patterns with one atrial ostium or three atrial ostia on the left. Our study is important in terms ofbeing the largest series to date with 503 patients. The type that involves three separate atrial ostia on the left classified as L3 (Left)is not included in Marom’s classification.Conclusion: MDCT accurately identifies pulmonary venous anatomy in detail, which is important in RFA preparation.

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