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Posterior vein of right lung

The posterior vein of the right lung is a segmental pulmonary vein that drains the posterior segment (S2) of the right upper lobe. It courses posteriorly within the right lung parenchyma, accompanying the posterior segmental bronchus (B2) and its arterial branch, before converging at the right hilum. The vein typically empties into the right superior pulmonary vein (RSPV), which then drains directly into the left atrium.

Anatomically, the posterior vein is an important component of right pulmonary venous drainage, along with the apical (S1) and anterior (S3) segmental veins, which also converge into the RSPV. In some cases, the posterior vein may have a separate entry into the left atrium or form a common trunk with other veins.

This venous structure is clinically significant for atrial fibrillation ablation, lung segmentectomy, and thoracic imaging, where precise mapping of segmental veins prevents surgical and interventional complications.

Synonyms

  • Right upper lobe posterior segmental vein (V2)

  • Posterior vein of right upper lobe

  • Tributary of right superior pulmonary vein

Function

  • Drains oxygenated blood from the posterior segment (S2) of the right upper lobe

  • Empties into the right superior pulmonary vein → left atrium

  • Provides surgical and imaging landmark for right upper lobectomy and AF ablation

Tributaries

  • Segmental venules from the posterior segment (S2) of the right upper lobe

MRI Appearance

T1-weighted images:

  • Appears as a flow void (black lumen) posterior to the right upper lobe bronchus

  • Surrounded by hyperintense hilar fat, aiding identification

T2-weighted images:

  • Seen as a signal void against bright lung background

  • Intraluminal thrombus may appear intermediate to high signal depending on age

STIR:

  • Suppresses fat, improving contrast between the vein and adjacent hilar structures

  • Highlights perivascular edema, inflammation, or tumor infiltration as hyperintense

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Enhances brightly and homogeneously, demonstrating clear drainage into the RSPV

  • Filling defects indicate venous stenosis, thrombosis, or anomalous return

MRI Non-Contrast Cardiac-Gated 3D Imaging (Whole-heart):

  • Provides a 3D reconstruction of the posterior vein entering the RSPV

  • Useful for pulmonary venous mapping before AF ablation or surgical planning in right upper lobectomy without contrast administration

CT Appearance

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

  • Best modality for visualization of the posterior vein

  • Contrast opacifies the vein and defines its convergence into the RSPV

  • Multiplanar and 3D reconstructions show its course relative to bronchi and arteries

  • Detects stenosis, anomalous venous drainage, or post-ablation narrowing

  • Differentiates pulmonary veins from hilar masses or lymphadenopathy

CT images

Posterior vein of right lung CT axial image -img-00000-00000

CT images

Posterior vein of right lung CT axial image -img-00000-00000_00001