title: Evaluation of pulmonary vein variations and anomalies with 64 slice multi detector computed tomography.
abstract: Pulmonary Veins are one of the major structures of circulation. In the last decade, pulmonary veins have been known to play an important role as the triggering focus of the electrical activity in atrial fibrillation. Primary treatment method of AF is RF ablation of the focus. For the best ablation, the anatomy of PVs should be well established before the procedure.
  
  
  METHODS
  In our radiology department, 783 patients underwent computed tomography angiography between January 2008 and May 2010. Patients were referred for coronary CTA because of known or suspected coronary artery disease or computed tomography pulmonary angiography (CTPA) because of known or suspect pulmonary embolism. All scanning was performed on Philips Brilliance 64 slice Multidetector CT. The group consisted of 402 male and 381 female patients with the average age of 48 (range 14-89). CT data of patients were retrospectively reviewed to identify the PV anatomy and to determine anatomic variants and anomalies.
  
  
  RESULTS
  In the majority of cases, two pulmonary veins drain into the left atrium on each side. Eighteen and eight variations were found in the right and left sides, respectively. Most frequent combined variations were 2R-4L (32.3%) and 4L was the more frequent single variation type (76%). In addition to that one Situs inversus totalis (0.12%), two partial anomalous pulmonary venous returns (0.25%) and one scimitar syndrome (0.12%) were found.
  
  
  CONCLUSIONS
  This study showed that multiple types of variations of PVs can be found with increasing patient number. Therefore, for the successful ablation and surgery without any complications, the anatomy of PVs should be known before the procedure. MDCT is a reliable imaging method for the detailed cross-sectional and 3D anatomy.
authors.affiliation: Dicle University School of Medicine, Department of Radiology, Diyarbakir, Turkey. guvenmakale@gmail.com
authors.forename: Guven
authors.initials: G
authors.lastname: Tekbas
authors.forename: Hatice
authors.initials: H
authors.lastname: Gumus
authors.forename: Hakan
authors.initials: H
authors.lastname: Onder
authors.forename: Faysal
authors.initials: F
authors.lastname: Ekici
authors.forename: Cihad
authors.initials: C
authors.lastname: Hamidi
authors.forename: Ebru
authors.initials: E
authors.lastname: Tekbas
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gulicetincakmak
authors.forename: Celal
authors.initials: C
authors.lastname: Yavuz
authors.forename: Aslan
authors.initials: A
authors.lastname: Bilici
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000706:statistics & numerical data*; D015995:Prevalence; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult