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Great pancreatic vein

The great pancreatic vein (vena pancreatica magna) is one of the largest venous tributaries of the pancreas, usually draining the body of the pancreas. It courses posteriorly through the pancreatic parenchyma and empties into the splenic vein, which then joins the superior mesenteric vein (SMV) to form the portal vein.

The great pancreatic vein often runs parallel to the great pancreatic artery (arteria pancreatica magna, a branch of the splenic artery), forming an artery–vein pair. Variations are common, with occasional drainage into the portal vein or superior mesenteric vein instead of the splenic vein.

Clinically, the great pancreatic vein is significant in pancreatic surgery (distal pancreatectomy, Whipple procedure), portal hypertension, and pancreatic tumors. In radiology, identifying its course and patency is essential for evaluating venous invasion in pancreatic carcinoma and collateral pathways in portal hypertension.

Synonyms

  • Vena pancreatica magna

  • Pancreatic great vein

  • Splenic tributary of pancreas

Function

  • Drains venous blood from the pancreatic body and adjacent regions

  • Empties primarily into the splenic vein

  • Contributes to portal venous inflow via splenic vein → portal vein

  • Provides collateral venous drainage in portal hypertension

MRI Appearance

T1-weighted images:

  • Vein appears as a flow void (dark lumen) coursing posterior to pancreatic body

  • Surrounded by intermediate signal pancreatic parenchyma

T2-weighted images:

  • Lumen appears as a signal void

  • Perivenous edema or inflammatory change in pancreatitis shows hyperintensity

STIR:

  • Suppresses fat and highlights peripancreatic inflammation, edema, or venous engorgement

  • Useful in acute pancreatitis and venous thrombosis

T1 Fat-Saturated (Pre-contrast):

  • Lumen often shows intermediate signal intensity standing out against suppressed peripancreatic fat

  • Helps delineate venous course

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Great pancreatic vein enhances brightly in the venous phase

  • Useful for detecting venous thrombosis, collateral formation, or tumor invasion

MRV (Magnetic Resonance Venography):

  • Depicts the great pancreatic vein joining splenic vein

  • Shows variant drainage patterns and patency assessment

  • Helpful for surgical mapping and portal hypertension evaluation

CT Appearance

CT Pre-Contrast:

  • Vein appears as a linear soft-tissue density posterior to pancreas

  • Thrombosis may appear as hyperdense filling defect in acute phase

CT Post-Contrast:

  • Vein enhances in the venous phase, draining into the splenic vein

  • Important for identifying patency, thrombosis, or invasion by pancreatic carcinoma

CTV (CT Venography):

  • High-resolution venous mapping with multiplanar and 3D reconstructions

  • Demonstrates origin, course, and drainage of the great pancreatic vein into splenic vein

  • Detects venous occlusion, collateral pathways, and surgical anatomy

  • Gold standard for preoperative evaluation in pancreatic and portal venous surgery

MRI image

Great pancreatic vein AXIAL MRI anatomy image -img-00000-00000

CT image

Great pancreatic vein CT AXIAL IMAGE