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Anterior vein of left lung

The anterior vein of the left lung is a segmental pulmonary vein that drains the anterior segment (S3) of the left upper lobe. It runs anteriorly in the lung parenchyma, courses in front of the left upper lobe bronchus and pulmonary artery, and joins the left superior pulmonary vein (LSPV) at the hilum. The LSPV then empties into the left atrium.

In many cases, the anterior vein may also receive tributaries from the lingular segments (S4–S5), especially when accessory venous pathways are present. Anatomical variations are frequent, with some individuals showing separate ostia for the anterior and apicoposterior veins into the LSPV.

This vein is clinically important in pulmonary vein isolation for atrial fibrillation, lung resections, and transplant surgery, where precise knowledge of venous drainage prevents complications.

Synonyms

  • Left upper lobe anterior segmental vein (V3)

  • Vena anterior pulmonis sinistrae

  • Tributary of left superior pulmonary vein

Function

  • Drains segment S3 (anterior segment of left upper lobe)

  • May contribute venous return from lingular segments in some variants

  • Returns oxygenated blood into the left superior pulmonary vein → left atrium

  • Serves as an important anatomical landmark in pulmonary vein mapping and surgery

Tributaries

  • Segmental venules from anterior segment (S3) of the left upper lobe

  • Occasionally, accessory venules from lingula (S4–S5)

MRI Appearance

T1-weighted images:

  • Appears as a flow void (black lumen) at the anterior hilum of the left upper lobe

  • Seen relative to the pulmonary artery and bronchus

T2-weighted images:

  • Appears as a linear flow void; intraluminal thrombus would alter to intermediate/high signal

STIR:

  • Fat suppression enhances delineation of the vein against mediastinal fat

  • Perivascular pathology (edema, tumor infiltration) appears hyperintense

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Enhances homogeneously, clearly showing the vein draining into the LSPV

  • Helpful in detecting thrombosis, narrowing, or anomalous drainage

MRI Non-Contrast Cardiac-Gated 3D Imaging:

  • Provides 3D view of the anterior vein course into the LSPV

  • Used for AF ablation planning and segmentectomy mapping without contrast

CT Appearance

CT Post-Contrast (CT Pulmonary Venography / CCTA):

  • Contrast opacifies the anterior vein, its confluence with the LSPV, and relationship to bronchus/artery

  • Multiplanar and 3D reconstructions define segmental drainage and venous variations

  • Critical for detecting stenosis, anomalous return, or post-ablation narrowing

CT Image

Anterior vein of left lung CT axial image -img-00000-00000

MRI image

Anterior vein of left lung MRI AXIAL IMAGE