Topics

Topic

design image
Inferior lingular vein of left lung

The inferior lingular vein is a segmental tributary of the left superior pulmonary vein (LSPV). It specifically drains the inferior lingular segment (S5) of the left upper lobe. The vein runs along the inferior aspect of the lingula, accompanying the segmental bronchus and artery, before joining the superior lingular vein (from S4) to form the lingular vein. This lingular vein then empties into the left superior pulmonary vein, which drains into the left atrium.

The lingular venous system is anatomically equivalent to the venous drainage of the right middle lobe. Variants are common, with separate ostia for lingular veins into the LSPV or accessory connections to other segmental veins. The inferior lingular vein is surgically and electrophysiologically important for pulmonary resections, lung transplantation, and pulmonary vein isolation in atrial fibrillation.

Synonyms

  • Left S5 segmental vein

  • Inferior lingular segment vein

  • Tributary of the left superior pulmonary vein

Function

  • Drains oxygenated blood from the inferior lingular segment (S5) of the left upper lobe

  • Joins the superior lingular vein (S4) to form the lingular vein

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

  • Serves as an anatomical marker in segmentectomy and pulmonary venous mapping

Tributaries

  • Segmental venules from S5 (inferior lingular segment)

MRI Appearance

T1-weighted images:

  • Appears as a small flow void (black lumen) in the lingular region of the left upper lobe

  • Surrounded by bright fat and adjacent to bronchovascular structures

T2-weighted images:

  • Displays as a linear flow void; intraluminal thrombus would increase signal intensity

STIR:

  • Fat suppression delineates the inferior lingular vein within hilar and lingular fat planes

  • Perivascular edema or inflammation appears hyperintense

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Enhances brightly and homogeneously

  • Clearly shows the union with the superior lingular vein to form the lingular vein and its drainage into the LSPV

  • Useful for identifying thrombosis, anomalous drainage, or post-ablation narrowing

MRI Non-Contrast Cardiac-Gated 3D Imaging:

  • Provides 3D visualization of the inferior lingular vein joining the superior lingular vein

  • Critical for AF ablation planning, surgical segmentectomy, and anatomical mapping without contrast

CT Appearance

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

  • Contrast clearly opacifies the inferior lingular vein, its convergence with the superior lingular vein, and entry into the LSPV

  • Multiplanar and 3D reconstructions highlight segmental venous anatomy and variations

  • Key for thoracic surgery, AF ablation guidance, and transplant evaluation

CT image

Inferior lingular vein of left lung CT axial image -img-00000-00000_00001